Clinical Reimbursement Specialist

Clinical Reimbursement Specialist

Support Care. Strengthen Access. Make a Real Impact.

The Visiting Nurse Association Health Group (VNAHG) is a mission-driven nonprofit that has been trusted by New Jersey families for more than 110 years. Our team delivers a wide range of services, including home health, rehabilitation, hospice, and community-based care, so individuals can receive the support they need where they feel most comfortable. Joining VNAHG means contributing to a mission that puts people first and strengthens the health of our communities.

Position Summary

Responsible for obtaining and verifying insurance coverage, securing required authorizations, and reporting third-party reimbursement information to ensure accurate coverage and timely payment.

Principal Responsibilities

• Supports organization's mission by striving for excellence in all aspects of the job with a focus on positive interpersonal relationship with co-workers
• Assures accurate and timely verification of reimbursement information to ensure coverage of insurance
• Assure authorization (if required by payer) is obtained in a timely manner
• Perform payer coverage duties as assigned
• Assists in designing, implementing and maintain a manual of insurance resource information in collaboration with the Manager of Clinical Reimbursement
• Establishes and maintains positive working relationship and communication with external and internal groups
• Monitors quality and appropriateness of services and processes
• Other duties as assigned
• Adheres to the organization's policy in regards to absenteeism and appearance

Job Competencies & Minimum Qualifications

• High School Diploma/GED required; Associates degree preferred
• Must have prior experience working with managed care and workman's compensation carriers
• Knowledge of third party reimbursement required
• Strong computer skills
• Excellent written and verbal communication skills
• Excellent interpersonal and organizational skills

Working Conditions/Physical Demand

Business Office Environment within a fast paced department with phone and computer use Working indoors with client/customer contact needed via telephone communication

What You'll Love About Working Here:

• A team that supports you Work in a collaborative, encouraging environment where your contributions are valued.
• Room to grow Access meaningful growth and development opportunities that help you build your career.
• Work with purpose Play a key role in ensuring patients receive the coverage and care they depend on.
• Benefits that care for you Enjoy comprehensive benefits designed to support your well-being at work and at home.

In compliance with New Jersey's Pay Transparency Act, the compensation range for this position is USD $16.00 to USD $24.00. When determining an offer, VNA Health Group considers factors such as the scope and responsibilities of the role, the candidate's work experience, education/training, relevant skills, internal pay equity, and market and organizational conditions. For more details about our benefits, please visit our Careers page.

VNAHG provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.