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Insurance Coordinator - Orthopedics

Location: Englewood, NJ, United States
Date Posted:



Insurance Coordinator

Holy Name is New Jersey's last remaining independent, Catholic health system, comprising a comprehensive 361-bed acute care medical center, a cancer center, medical fitness center, residential hospice, nursing school, and physician network. The system has a national reputation for providing culturally sensitive care to a diverse population, drawing patients from across the New York City region to its specialty centers and renowned doctors. Holy Name's mission to provide technologically advanced, compassionate and personalized care extends across a continuum that encompasses education, prevention, diagnosis, treatment, rehabilitation and wellness maintenance. The system is known as a high-quality, low-cost provider of extraordinary clinical care given by compassionate, highly trained physicians and staff.

A Brief Overview
The Insurance Coordinator is responsible for verifying and obtaining authorizations for all required radiology exams and document approvals. They will be responsible for obtaining information on the patient's eligibility status with the insurance companies to ensure proper coverage and payment for services. Responsible for the complete and accurate verification/authorization of all patients in an orderly, expeditious and pleasant manner.

What you will do

  • Obtains and verifies all demographic, insurance, and, clinical information from referring physicians’ office.
  • Ensure accurate and timely data entry into the RIS system for each patient, according to established standards.
  • Utilize telephone voice response systems and website solutions to obtain information on patients’ eligibility status with insurance companies.
  • Work with patients to obtain complete and correct insurance information, discuss eligibility results, and alternative payment methods if denied.
  • Properly analyze various payor eligibility responses to find the information needed to complete verifications.
  • Obtain and confirm insurance pre-authorizations when necessary.
  • Follow all HIPPA, compliance, privacy and confidentiality standards.
  • Maintain patient confidentiality at all times.
  • Communicate with patients, referring physicians, co-workers, and all team members in a courteous and professional manner.
  • Maintain insurance verification log of accounts verified.
  • Contact insurance providers via online or phone to review status of authorizations.
  • Has an understanding of computer terminals and printers in order to perform daily functions.
  • Follows up with patient and or referring physician in a timely and personable manner should any information be found incorrect/incomplete.
  • Replies to inquiries from patients, referring physician looking for information clearly and in a timely manner
  • Answers telephone and other incoming communications in timely and customer-service oriented manner.
  • Demonstrates good phone skills.
  • Prioritizes/organizes work assignments and adjusts priorities based on changing situations.
  • Performs all duties, as assigned.

Education Qualifications

  • High School Diploma or equivalent experience Required

Experience Qualifications

  • Experience with computerized data entry Required

Knowledge, Skills, and Abilities

  • Ability to work independently.
  • Knowledge of medical terminology, ICD 10 codes, Diagnosis codes.
  • Requires good communication skills and telephone technique.
  • Must be able to work well under pressure.

Holy Name is a mission-driven facility whose quality standards and philosophy are rooted in the principles of its founders, the Sisters of St. Joseph of Peace. Those principles are exercised daily by the Medical Center's dedicated and talented team of physicians, nurses, allied health employees, and a wide variety of non-clinical administrative and operational staff members. Holy Name is an Equal Opportunity Employer.