Precertification Coordinator - Per Diem - Day

Hackensack Meridian Health•Edison, NJ

3d•$20

About The Position

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. To provide essential support to the clinical office staff, physicians, and patients by efficiently coordinating all aspects of the insurance pre-certification and referral process. This role acts as a key liaison between the practice, patients, and insurance companies to ensure timely authorization for medical services.

Requirements

High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
Minimum 2-4 years of experience in a physician practice or ambulatory healthcare setting. Direct experience with insurance authorization, verification, and referral processes is required.
Strong organizational skills with the ability to effectively prioritize and manage multiple tasks.
Excellent communication, written, and interpersonal skills.
Proficiency with Microsoft Office Suite (Word, Excel).
Experience with Electronic Medical Records (EMR) systems.
Familiarity with standard office equipment (e.g., telephones, fax machines, copiers).
Ability to work collaboratively as part of a patient-centered team.

Nice To Haves

Familiarity with specific insurance carrier portals and systems (e.g., Envoy).

Responsibilities

Identifies, prioritizes, and processes all physician-ordered procedures, tests, and referrals requiring pre-certification, based on the urgency and date of the upcoming appointment.
Utilizes online portals and direct phone contact with insurance companies to submit required clinical information and obtain authorizations in a timely manner.
Documents all authorization and referral details, including approval numbers and status, accurately and promptly within the Electronic Medical Record (EMR) and appropriate billing systems.
Maintains a detailed tracking log or spreadsheet of all initiated requests, including submission dates, status updates, reasons for any delays, and final approval dates.
Coordinates with internal staff and external departments to schedule patient appointments for tests, procedures, therapies, and evaluations as required.
Serves as a point of contact for patient inquiries, answering incoming calls, screening and routing calls appropriately, monitoring voicemail, and relaying messages to ensure clear and continuous communication.
Performs patient support functions as needed, which may include assisting with registration, updating demographic and insurance information, and confirming appointments.
Maintains up-to-date knowledge of the various pre-certification requirements for participating insurance and managed care plans.
Other duties and/or projects as assigned.
Adheres to HMH Organizational competencies and standards of behavior.