Insurance Verification and Authorization Specialist (Temp to Perm)

Job Description

Job Description

Hiring now in South New Jersey for an  Insurance Verification and Authorization Specialist to serve as a key resource on insurance coverage, benefits, and policy guidelines. In this role, you’ll maintain patient accounts, verify insurance details, process payments, and communicate with both internal teams and external partners to ensure accuracy and efficiency. The right person for this role thrives in a fast-moving setting, juggling competing priorities with accuracy and a polished, professional approach. They bring strong communication, organizational, and problem-solving skills — and can work confidently on their own while adapting to evolving systems and procedures. If this sounds like you, apply today!

RESPONSIBILITIES:

• Provide patient balance estimates, collect patient payments and verify insurance coverage and benefits for all payers, including Medicare, Medicaid, and commercial insurances
• Answer and respond to telephone, voicemail, email, and faxed inquiries from internal and external customers, which include clients, patients, and insurance carriers, while providing exceptional customer service
• Explain insurance coverage and benefits to patients, as necessary
• Contact patients and external customers regarding inactive insurance coverage to obtain updated insurance information or obtain referrals
• Initiate, submit and obtain prior authorizations
• Possess current knowledge of insurance carrier guidelines, clinical policies, and state guidelines pertaining to referrals and prior authorization
• Process, sort, and direct incoming and outgoing mail to the appropriate teams and departments
• Maintain patient accounts by appropriately notating, updating, and collecting patient demographic, and insurance information
• Request medical records and other patient/provider information, when appropriate
• Process credit card transactions received from patients and insurance carriers
• Handle patient financial hardship applications and reviews requests for account adjustments
• Supply the management team with immediate feedback on issues affecting workflow, reimbursement, and customer service as well as identifies and escalates opportunities for process improvement to management team
• Identify insurance contract opportunities/requirements and communicates to the Payor Relations department
• Adhere to appropriate quality control, confidentiality, and HIPAA guidelines
• Attend staff meetings and report on monthly performance and activities

QUALIFICATIONS:

• Bachelor’s degree, preferred
• Minimum 3 years in customer service, insurance verification, authorization and insurance billing required
• Previous experience with medical claims processing, insurance verification, authorization, medical records and insurance terminology, required
• Competent with Windows PC Applications, including Microsoft Word and Microsoft Excel.

Note: Qualified candidates will be contacted within 2 business days of application. If an applicant does not meet the above criteria, we will keep your resume on file for future opportunities and may contact you for further discussion.
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