Authorization/Referral Coordinator - Surgical in Somers Point, New Jersey at Shore Medical Center

General/Vascular Surgery Division

The authorization coordinator will be responsible for obtaining all scheduled vascular studies, and in office surgical procedures, verifying insurance eligibility and coverage and confirming appointments

Responsibilities

• Monitors upcoming vascular department schedule, obtains authorizations and confirms appointments
• Secures insurance information, eligibility, benefits and authorizations for specific testing
• Responsible for identification and authorization of all codes that may be used throughout complex and variable patient treatments
• Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans
• Collaborates with other departments to ensure documentation is received prior to services
• Assists with medical necessity documentation to expedite approvals and ensure the appropriate follow-up
• Documents authorizations and progress of authorizations in the patient’s chart
• Ensures all updates to documentation in patient’s file are completed in a timely manner
• Ensures compliance with appropriate industry, state, and federal regulations
• Safeguards strict confidentiality of all health records, member information, and meets HIPAA guidelines
• The candidate must be well organized, detail oriented, efficient, dependable with excellent time management and computer skills
• Performs other duties as assigned

Requirements

• 1+ years of insurance authorization experience required
• Vascular experience preferred

• Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers and other funding sources
• Outstanding written and verbal communication skills, with close attention to detail
• Demonstrated ability to analyze data and work independently within a fast-paced work environment
• Proficiency in various computer applications
• Excellent organizational and prioritization skills
• Athena experience preferred

Salary Range (Based on Experience)

• $18.04 - $25.53

Why Join Us?

At Shore Physicians Group, we work hard and take pride in accomplishing our mission statement of “Treating People Well”. We are looking for employees who strive to be the best in their field and enjoy exchanging knowledge in an interactive environment.

Shore Physicians Group offers a professional, enjoyable work environment, and generous benefits including:

• 401(k)
• 401(k) matching
• Medical/Dental/Vision insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Certification reimbursement
• Referral incentive program
• Local community employee discounts
• Free Parking

Additional Information

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required.
• This job description should not be construed as an exhaustive statement of duties, responsibilities or requirements, but a general description of the job. Nothing contained herein restricts the company's rights to assign or reassign duties and responsibilities to this job at any time.
• Shore Physicians Group is an Equal Opportunity Employer. All applicants will receive consideration for employment without regard to sex, affectional or sexual orientation, gender, gender identity, orientation or expression; marital status, domestic partnership status, civil union status, pregnancy, race, creed, ancestry, color, ethnicity, national origin, age, disability, religion, genetic information, or veteran status or any other basis prohibited by law.