Careers
04-34079

Financial Clearance Specialist - Internal Medicine - Cape May

Location: Cape May Court House, NJ  |  Position Status: Full Time  |  Position Shift: Days

AtlantiCare Physician Health Network is currently seeking an insurance verification specialist. In this role, you will be responsible for obtaining verification of all insurance benefits for patients and maintaining/entering that information to reflect the most up-to-date coverage. Your duties may also involve obtaining pre-authorization for services, which requires effective phone communication skills. After verifying coverage, you will determine benefit-level coverages and patient financial responsibility. Bilingual communication skills are a major plus. Attention to detail is key. This role requires the use of Cerner/Oracle revenue cycle and practice management modules and various additional applications.
 
The incumbent will:

  • Verify insurance eligibility for patients and referrals by using various verification tools/apps or contacting the insurance carrier directly.
  • Update insurance/benefit information for existing patients.
  • Review schedules for upcoming patient appointments.
  • Enter new demographics into Cerner.
  • Review patient copays/deductibles and enter into the Cerner.
  • Coordinate with front end regarding registration/eligibility errors.
  • Enter insurance, referrals, authorizations and other related patient information into Cerner.
  • Answer questions from patients, physician practice staff and insurance companies.
  • Obtain pre-authorization for recommended services and procedures.
  • Determine and communicate patient financial responsibilities.
  • Communicate and help resolve eligibility and authorization-related denials.
  • Manage worklists, queues and eligibility rejection reports.
  • Participate in educational activities and attend monthly staff meetings.
  • Assist in the development of communication and processes to improve overall departmental performance.

 
QUALIFICATIONS

  • EDUCATION: High school diploma or GED certificate.
  • EXPERIENCE: 1-2 years of relevant experience preferred; medical billing experience preferred. General knowledge of CPT codes and basic medical terminology preferred. Requires extensive computer/application use, phone communication skills and comfort with significant computer use. Bilingual ability (English/Spanish) preferred.

 
WORK ENVIRONMENT
Potential for exposure to blood-borne pathogens along with infectious diseases (refer to blood-borne pathogen requirement).

Essential functions of this position are listed on the Assessment and Evaluation Tool.
 
REPORTING RELATIONSHIP
The above statement reflects the general details considered necessary to describe the principal functions of the job, as identified, and shall not be considered as a detailed description of all work requirements that may be inherent in the position.


AtlantiCare is an equal opportunity employer that takes affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability.
Amanda Pastore
Talent Acquisition Partner
Applicants only. We are not accepting inquiries or solicitations from recruiters/search firms.

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We believe that healthcare should be a rewarding career. That’s why we offer excellent compensation, exceptional health and wellness benefits, and internal resources and programs to support professional growth for our team members. Here, you’ll find everything you need to pursue your calling of caring for others, knowing that you’re working for an organization dedicated to your overall well-being.

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