Job Details
Job Type: Full Time
Date Posted:
Shift: Day
Req. Number: 20056923
MAJOR FUNCTION:
The Pre-Service/Pre-Cert Representative is responsible for ensuring all outpatient insurance requirements are completed in advance of patient’s scheduled appointment date. Representative must validate all insurances in HDX or via insurance portals, as needed. Representative is also responsible for ensuring authorizations are obtained via Recondo tool and/or to obtain hospital authorizations on behalf of physician practices, when applicable, prior to the patient’s scheduled procedure/testing date.
QUALIFICATIONS:
Education & Experience:
- High School Diploma or GED equivalent required.
- Some college and/or CHAA certified preferred.
- Minimum of one-year experience working in a hospital registration area or physician’s office verifying medical insurance coverage via online portals- Navinet, Medicaid, Medicare- required.
Certification/Licensure:
- N/A
Knowledge & Skills:
- Working knowledge of insurance plans, products, benefits, and authorization process and requirements preferred.
- Familiarity with 3rd party vendor process used for authorization submission via Evicore, AIM, GEMS preferred.
- Ability to organize accounts, work independently, and take direction as needed in addition to being detail oriented is a must.
- Must be able to work in a fast-paced environment with a diverse population while maintaining a professional attitude and providing great customer service.
- Computer proficiency required.
- Typing skills minimum 30-40 WPM required.
Physical Requirements: N: Never O: Occasionally (<20%) F: Frequently (20%-80%) C: Constantly (>80%)
Lifting <20lbs C Standing F Sitting C
Lifting 20-50lbs O Climbing O Kneeling O
Lifting>50lbs N Crouching O Reaching F
Carrying F Hearing C Walking F
Pushing F Talking C Vision C
Environmental Conditions:
Noise F Varied Temperatures O Cleaning Agents F
Noxious odors N Patient Exposure N Operative Equipment N
At Inspira Health, you’ll join with the area’s most dedicated and distinguished team to bring quality and compassionate care to our communities. We focus on clinical excellence, providing evidence-based care to help each patient achieve the best possible outcome. The scope and depth of our network can open many doors for your learning and career growth.
Our charitable nonprofit health care organization serves communities across southern New Jersey. The network, which traces its roots to 1899, comprises three hospitals, a comprehensive cancer center, sleep medicine, cardiac testing, digestive health and wound care, urgent care, imaging and rehabilitation, and primary and specialty physician practices in Gloucester, Cumberland, Salem and Camden counties.
Inspira is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, creed, color, national origin, ancestry, age, marital status, affectional or sexual orientation, familial status, disability, liability for service in the Armed Forces of the United States, nationality, sex, gender identity or expression.
Job Details
Job Type: Full Time
Date Posted:
Shift: Day
Req. Number: 20056923