Insurance Mgmt Specialist I- Full Time, Days, Atlantic Visiting Nurse, Morristown NJ

Duties & Responsibilities:

Communication

• Function as a liaison between external Insurance Companies and internal staff to ensure patient needs are met.
• Notify internal staff when patient updates are required.
• Communicates with CAC & Clinical Teams to ensure required financial information is available to review with patient.
• Communicate with Clinical Teams to request necessary information for ongoing authorizations in a timely manner.

Insurance Verification

• Verifies patient insurance for all incoming referrals for all payers.
• Verifies patient insurance during course of episode if payer change occurs or a need for re-verification arises.
• Participates in the re-verification at designated times of year, i.e. open enrollment period.
• Documents all verification information in EPIC to ensure CAC, clinical teams and other departments are aware of results.

Authorization

• Obtain timely initial precertification and authorization for initial services when required.
• Understands and enters pending authorization as required.
• Demonstrated knowledge of payors and required documentation for precertification and authorization.
• Obtains timely authorization for ongoing authorizations for home care and hospice services from select payers online, by telephone or fax per company requirements.
• Documents all authorization information in Epic to ensure clinical communication, as well as accurate system notification of ongoing needed authorization.
• Reviews additional service request for completeness of information, accuracy and presence of required clinical data.
• Request and /or submit clinical documentation for authorization/reauthorization in Epic, prepares updates as indicated.

Department Workflow

• Ensures coverage of department for assigned hours of operations.
• Manages assigned patient, insurance and/or acct EPIC work queues, ensuring accurate and timely completion.
• Supports data integrity by running or working reports to identify and correct areas of inaccuracy.
• Participates as needed in the follow-up and correction of insurance and/or authorization information, including the process required for payer changes, or obtaining retro authorization.
• Participates as directed by Supervisor of Verification/Authorization in the EVV process.

Other Duties

• Performs other duties as assigned.

1. High school diploma or GED.

Preferred:

1. College degree preferred.
2. Knowledge/ Experience with obtaining authorizations, familiar with insurance verifications preferred.

At Atlantic Health System, our promise to our communities is that anyone who enters anyone of our facilities, receive the highest quality care delivered at the right time, at the right place, and at the right cost. That commitment is also echoed in the respect, development and opportunities we give to our more than 18,000 team members. Headquartered in Morristown, New Jersey, we are one of the leading non-profit health care systems in the state, and committed to creating a Trusted Network of Caring®. Our facilities and sites of care include:

• Morristown Medical Center, Morristown, NJ
• Overlook Medical Center, Summit NJ
• Newton Medical Center, Newton, NJ
• Chilton Medical Center, Pompton Plains, NJ
• Hackettstown Medical Center, Hackettstown, NJ
• Goryeb Children's Hospital, Morriston NJ
• Atlantic Rehabilitation
• Atlantic Home Care and Hospice

We also have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group.  We are part of Atlantic Accountable Care Organization, one of the largest ACOs in the nation, and are a member of AllSpire Health Partners.
We receiver awards and recognitions for what we provide to our patients, team members and communities.  Below are just a few of our accolades:

• 100 Best Companies to Work For ® and FORTUNE® magazine (13 years in a row)
• Best Places to Work in Healthcare - Modern Healthcare
• 150 Top Places to work in Healthcare - Becker's Healthcare
• 100 Accountable Care Organizations to Know - Becker's Hospital Review
• Best Employers for Workers over 50 - AARP
• Gold-Level "Well Workplace": Wellness Council of America (WELCOA)
• CEO Cancer Gold Standard ™
• One of the 100 Best Workplaces for Millennials" Great Place to Work® and FORTUNE® magazine
• One of the 20 Best Workplaces in Health Care:  Great Place to Work® and FORTUNE® magazine
• Security 500: Security Magazine
• Official Health Care Partner of the New York Jets
• NJ Sustainable Business                                                                                                                                                        

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 System 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

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Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.
EEO STATEMENT
Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.