Mgmt Specialist

Position: Insurance Mgmt Specialist I
Location: Township of Morris
Job Description...
Performs review of service requests for completeness of information, collection, and acquisition of structured clinical data from our Care Access Center (CAC).Handles screening for precertification requests from Epic WQ.Obtains timely authorization for home care and hospice services from select payers online, by telephone or fax per company requirements.
Acts as a liaison between the clinicians and the Utilization Review/Medical Management departments at insurance companies.
Enter pending authorizations into Epic.
Prepare updates on patient condition with appropriate recommendations to ensure authorizations.
Function as a liaison between external Case Managers/Insurance Companies and internal staff.
Notify internal staff when patient updates are required.
Request and /or submit clinical documentation for authorization/reauthorization in Epic.
Work with the Billing Department in obtaining retro authorizations with denials and appeals from insurance companies.
Performs other duties as needed.
Opportunity to work hybrid (2 days) after intro period Qualifications
High school diploma or GED.College degree preferred.
Experience with obtaining authorizations, familiar with insurance verifications.
Epic experience a plus.
About Us
At Atlantic Health System, our promise to our communities is that anyone who enters anyone of our facilities, receive the highest quality care delivered at the right time, at the right place, and at the right cost. That commitment is also echoed in the respect, development and opportunities we give to our more than 18,000 team members. Headquartered in Morristown, New Jersey, we are one of the leading non-profit health care systems in the state, and committed to creating a Trusted Network of Caring.
Our facilities and sites of care include:
Morristown Medical Center, Morristown, NJ Overlook Medical Center, Summit NJNewton Medical Center, Newton, NJChilton Medical Center, Pompton Plains, NJHackettstown Medical Center, Hackettstown, NJGoryeb Children's Hospital, Morriston NJ Atlantic Rehabilitation Atlantic Home Care and Hospice We also have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group. We are part of Atlantic Accountable Care Organization, one of the largest ACOs in the nation, and are a member of All Spire Health Partners.
We receiver awards and recognitions for what we provide to our patients, team members and communities. Below are just a few of our accolades:
100 Best Companies to Work For and FORTUNE magazine (13 years in a row)
Best Places to Work in Healthcare - Modern Healthcare
150 Top Places to work in Healthcare - Becker's Healthcare
100 Accountable Care Organizations to Know - Becker's Hospital Review Best Employers for Workers over 50 - AARPGold-Level 'Well Workplace':
Wellness Council of America (WELCOA)
CEO Cancer Gold Standard One of the 100 Best Workplaces for Millennia ls' Great Place to Work and FORTUNE magazine
One of the 20 Best Workplaces in Health Care:
Great Place to Work and FORTUNE magazine
Security 500:
Security Magazine Official Health Care Partner of the New York JetsNJ Sustainable Business
Our Home care and Hospice teams work with more than our patients, we work with their families, inside their homes and in their community. When you join our team, you also join theirs, bringing them your comfort, compassion, education, and expertise. We celebrate these close connections every day, by delivering the best comprehensive home care and hospice services possible.
EEO STATEMENT
Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.
About the Team
Home Care
With more than 100 years of experience, Atlantic Visiting Nurse provides high-quality nursing and rehabilitation services in the comfort of your own home. If you and your physician feel that you would benefit from home care - whether to prevent or postpone a hospitalization, or to help with recovery after a hospital stay - our team of nurses and rehabilitation experts can develop an individualized plan of care to meet your needs.
We're accredited by the Joint Commission and licensed by the New Jersey Department of Health. Atlantic Visiting Nurse - Home Health services are available to residents of Morris, Union, Essex, Sussex, Somerset and Warren counties in New Jersey.
Hospice
At Atlantic Visiting Nurse, we believe that those living with advanced illnesses should spend their final days in comfort and peace. Our compassionate, specialized care is designed to minimize patient suffering and to support families and loved ones?

Apply Job!