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Insurance Specialist

Job Details

Entry
Mount Laurel, NJ
Full Time
High School
$18.00 - $25.00 Hourly
None
Day

Description

Company Overview:

Persante HealthCare is a nationally recognized leading provider of sleep center management services, partnering with hospitals, physician practices, and patients across the nation. Our legacy of expertise in sleep-related disorders spans decades, with a history benchmarking the highest standards.

Job Overview:

As the Insurance Specialist, you will be responsible for obtaining and documenting insurance pre-certification/authorizations for outpatient diagnostic procedures. As the Insurance Precertification Specialist, you will be responsible for investigating claim appeals forwarded from the hospitals, submitting the appeals or retro authorizations, and properly documenting the appeal information.  Proficiency in working with payor on-line portals.  Excellent verbal and written communication skills. Detail oriented; ability to multi-task using multiple information systems.

Key Responsibilities:

  • Verification of benefits and Referral Requests.
  • Submits and ensures all data is submitted correctly and all documents are submitted to the insurance carriers for proper processing.
  • Obtains pre-authorization/pre-determination per payer requirements for services waiting to be scheduled and ensures authorization information is documented appropriately in the system.
  • Documents detailed communication with payers and provides all clinical documentation to the nurses for timely review.
  • Maintains patient confidentiality.
  • Using online and phone ability to communicate with insurance companies, obtain authorizations.
  • Cross trained within scope of departmental knowledge to assist in other areas upon request.

Qualifications

Qualifications:

                Required:

  • High School Diploma
  • 1 year working in the healthcare industry
  • Basic knowledge of health insurance payors

Preferred:

  • Bachelor's Degree
  • 3 years working in healthcare industry
  • Experience in utilizing payor portals online to verify benefits coverage and submit authorizations.

Education:

  • High Diploma Required

Experience:

  • At least 1 year of relevant experience required

Skills:

  • Experience utilizing electronic medical records software.
  • Working knowledge of health insurance benefits language associated with coverage and coding.
  • Proficient in the Microsoft Office Suite (Word, Excel, Outlook, PowerPoint, etc.).
  • Familiar with communicating via Microsoft Team or other online phone/chat tool.

Benefits:

  • Medical, Dental, Vision and Prescription Plans
  • Paid Time Off and  Holidays
  • 401(k) with Company Matching
  • Flexible Spending Plan
  •  Life Insurance
  • Short-Term & Long-Term Disability

Equal Opportunity Statement:

Persante is an equal opportunity employer. We embrace diversity and are committed to providing a workplace free from discrimination. We do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, or any other status protected by law. All qualified individuals are encouraged to apply. We believe that a diverse and inclusive workforce enhances our ability to innovate and serve our community effectively. We are dedicated to fostering an environment where everyone feels valued, respected, and supported. Thank you for considering Persante as your employer.

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