Insurance Mgmt Specialist I - Full Time, Hybrid, 9 AM - 5 PM, Monday - Friday, One Saturday, Atlantic Visiting Nurse, Morristown

Insurance Verification & Authorization Specialist

The Insurance Verification & Authorization Specialist is responsible for verifying insurance coverage, obtaining authorizations, and ensuring accurate documentation for patients receiving home health and hospice services. This role serves as a key liaison between insurance companies, clinical teams, financial counselors, and other internal departments to facilitate timely access to care while maintaining compliance with payer requirements.

The Specialist supports operational efficiency through proactive communication, management of Epic work queues, data integrity initiatives, and ongoing monitoring of authorization requirements throughout the patient's episode of care.

Principal Accountabilities:

Communication & Coordination:

• Serve as a liaison between external insurance companies and internal staff to ensure patient needs are met.
• Communicate with Clinical Admission Coordinators (CAC), clinicians, and other departments regarding insurance verification and authorization requirements.
• Notify appropriate team members when patient updates, documentation, or follow-up actions are required.
• Collaborate with clinical teams to obtain necessary clinical information for ongoing authorizations and payer requests.
• Facilitate timely communication regarding authorization status and payer requirements.

Insurance Verification:

• Verify insurance eligibility and benefits for all incoming referrals across multiple payer sources.
• Re-verify insurance coverage when payer changes occur or when re-verification is required during the course of care.
• Participate in annual re-verification activities during open enrollment and other designated periods.
• Accurately document verification findings within Epic to ensure visibility for clinical, financial, and operational teams.
• Maintain current knowledge of insurance plans, payer guidelines, and coverage requirements.

Authorization Management:

• Obtain timely initial authorizations and precertifications for services requiring payer approval.
• Manage pending authorizations and ensure accurate system documentation.
• Demonstrate knowledge of payer-specific authorization requirements and supporting documentation needs.
• Obtain ongoing authorizations and reauthorizations for home health and hospice services through online portals, telephone communication, or fax submission.
• Review authorization requests for completeness, accuracy, and required clinical documentation.
• Request, compile, and submit supporting clinical information necessary for authorization approvals.
• Document all authorization activity in Epic to support clinical communication and workflow management.

Department Operations:

• Maintain coverage of departmental responsibilities during assigned business hours.
• Manage assigned patient, insurance, and account work queues to ensure timely completion.
• Support data integrity initiatives through report review, auditing, and correction of discrepancies.
• Assist with payer changes, retroactive authorizations, and insurance corrections as needed.
• Participate in Electronic Visit Verification (EVV) processes and other departmental initiatives as directed.
• Contribute to process improvement efforts that enhance workflow efficiency and patient service.

Qualifications

Education:

• High School Diploma or GED required.
• Associate's or Bachelor's degree in Healthcare Administration, Business, Finance, or related field preferred.

Experience:

• Minimum of 2 years of healthcare insurance verification, authorization, patient access, revenue cycle, billing, or related healthcare experience required.
• Home Health, Hospice, Managed Care, or Health System experience preferred.
• Experience working with multiple payer sources including Medicare, Medicaid, Commercial Insurance, and Managed Care plans preferred.
• Prior experience using Epic strongly preferred.

Knowledge, Skills & Abilities

• Strong knowledge of insurance verification, precertification, authorization, and reimbursement processes.
• Understanding of Medicare, Medicaid, Managed Care, and commercial insurance requirements.
• Excellent organizational skills with the ability to manage multiple priorities and deadlines.
• Strong analytical and problem-solving abilities.
• Exceptional verbal and written communication skills.
• Ability to collaborate effectively with clinical, operational, and financial teams.
• High attention to detail and commitment to data accuracy.
• Proficiency with Epic and Microsoft Office applications preferred.

About Us

At Atlantic Health, our promise to our communities is; anyone who enters one of our facilities will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development, and opportunities we give to our more than 22,000 team members. Headquarters in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:

• Atlantic Health Morristown Medical Center, Morristown, NJ
• Atlantic Health Overlook Medical Center, Summit, NJ
• Atlantic Health Newton Medical Center, Newton, NJ
• Atlantic Health Chilton Medical Center, Pompton Plains, NJ
• Atlantic Health Hackettstown Medical Center, Hackettstown, NJ
• Atlantic Health Goryeb Children's Hospital, Morristown, NJ
• Atlantic Health CentraState Healthcare System, Freehold, NJ
• Atlantic Medical Group
• Atlantic Visiting Nurse
• Atlantic Mobile Health
• Atlantic Rehabilitation

We have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group.

We have received awards and recognition for the services we have provided to our patients, team members, and communities. Below are just a few of our accolades:

• Chosen for 17 years by Fortune as one of the magazine's "100 Best Companies to Work For."
• Atlantic Health Morristown and Atlantic Health Overlook Named by Newsweek as two of the "World's Best Hospitals" in 2026.
• Atlantic Health Morristown and Atlantic Health Overlook ranked within the top three hospitals in New Jersey by U.S. News & World Report's 2025-2026 Best Hospital rankings.
• Atlantic Health scored four "A" grades by The Leapfrog Group in its Fall 2025 Hospital Safety Grades, performance measures reflecting errors, accidents, injuries and injections, as well as systems hospitals have in place to prevent harm.
• Atlantic Health Morristown and Atlantic Health Overlook are New Jersey's only hospitals to be named among America's 50 Best hospitals by Healthgrades in 2026.
• Named by Becker's Healthcare as one of the "165 Top Places to Work in Healthcare 2026.
• Atlantic Health Morristown, Atlantic Health Overlook, Atlantic Health Chilton and Atlantic Health Newton all Forbes Top Hospitals for 2026.
• Named by Newsweek as one of America's Greatest Workplaces for Inclusion & Diversity 2025.
• Atlantic Health rated LEVEL 9 - 2025 CHIME Digital Health Most Wired.

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. Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted: Team Member Benefits

• Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
• Life & AD&D Insurance.
• Short-Term and Long-Term Disability (with options to supplement)
• 403(b) Retirement Plan: Employer match, additional non-elective contribution
• PTO & Paid Sick Leave
• Tuition Assistance, Advancement & Academic Advising
• Parental, Adoption, Surrogacy Leave
• Backup and On-Site Childcare
• Well-Being Rewards
• Employee Assistance Program (EAP)
• Fertility Benefits, Healthy Pregnancy Program
• Flexible Spending & Commuter Accounts
• Pet, Home & Auto, Identity Theft and Legal Insurance