Authorization/Verification Rep, Sleep Laboratory

Job Title: Authorization/Verification Rep

Location: SLEEP STUDY - CRANFORD NJ

Department Name: Sleep Lab

Req #: 0000244426

Status: Hourly

Shift: Day

Pay Range: $25.50 - $25.50 per hour

Pay Transparency:

The above reflects the anticipated hourly wage range for this position if hired to work in New Jersey.

The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience.

Job Overview:

Clarifies and verifies details of insurance coverage with private or government carriers and offers information to patients before medical services are provided. Tracks physician referrals and provides necessary details to billing staff. Provides clerical support for department needs (scheduling, scanning documents, phone calls).

Qualifications:

Required:

• 2 years insurance verification, medical billing or registration experience in a hospital or physician office
• High School Diploma

Preferred:

• Bilingual in Spanish highly preferred
• Working knowledge of medical insurance plans & products, coordination of benefits guidelines, and requirements for authorizations, pre-certifications and referrals
• Proficiency in working with payor online portals, as well as NaviNet, Passport or other third-party eligibility systems
• Proficiency in EPIC EMR systems

Scheduling Requirements

• Per Diem, as needed, the schedule varies

Essential Functions:

• Coordinate completion of prior authorization, if needed;
• Obtaining detailed benefits for ordered test;
• Verifying patient’s insurance eligibility;
• Submit requested medical documentation to insurance companies;
• Troubleshoot authorization related issues in the Practice Management System
• Work with insurance plans to pre-authorize and re-authorization of patient services
• Handles the verification of insurance benefits for customers
• Notifies customers of deductibles and co-insurance due
• Contacts primary care physicians in regard to referrals
• Contacts customer when needing to obtain information
• Regularly calls insurance companies to follow up
• Explores other payment options with customer when needed
• Maintain contact management regarding status of authorization and any additional documentation or information needed
• Verification of eligibility and benefits;
• Other duties as assigned (e.g., scheduling, appointment verification, other clerical work)
• Enter current authorizations into the Practice Management System
• Respond to internal/external inquiries relating to authorizations
• Follow up on insurance authorizations

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered, high-quality academic medicine in a compassionate and equitable manner, while delivering a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey—whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

RWJBarnabas Health is an Equal Opportunity Employer