Medical Insurance Verification Job in New Jersey

 

Job Duties:

• Performs telephonic support for online authorization of routine services
• Provides direct support to Primary Care practices and specialty care providers regarding utilization, authorization, and referral activities
• Becomes proficient in the use of ICD-9 and CPT codes
• Data entry referrals for non-complex services including inpatient and outpatient care
• Provides data entry for care which has been arranged by the Pre-Authorization Coordinators.
• Contacts providers with authorization, denial, and appeals process information
• Assists in educating and acts as a resource to primary care practices and specialty care providers
• Verifies eligibility of members and participating status of providers
• Determines member benefit coverage
• Performs other duties as required

 

Requirements:

• Demonstrated knowledge of insurances
• At least one year of pre-cert experience, including navigating websites for online benefit reviews
• Excellent computer, multi-tasking and phone skills
• The ability to work well under pressure (most of the paperwork is time sensitive)
• TEAM PLAYER and willing to be diversified job duties