Clinical Reimbursement Specialist

Position Summary: Responsible for obtaining and verifying insurance coverage, securing required authorizations, and reporting third-party reimbursement information to ensure accurate coverage and timely payment.

Principal Responsibilities

• Supports organization’s mission by striving for excellence in all aspects of the job with a focus on positive interpersonal relationship with co-workers
• Assures accurate and timely verification of reimbursement information to ensure coverage of insurance
• Assure authorization (if required by payer) is obtained in a timely manner
• Perform payer coverage duties as assigned
• Assists in designing, implementing and maintain a manual of insurance resource information in collaboration with the Manager of Clinical Reimbursement
• Establishes and maintains positive working relationship and communication with external and internal groups
• Monitors quality and appropriateness of services and processes
• Other duties as assigned
• Adheres to the organization’s policy in regards to absenteeism and appearance

Job Competencies & Minimum Qualifications

• High School Diploma/GED required; Associates degree preferred
• Must have prior experience working with managed care and workman’s compensation carriers
• Knowledge of third party reimbursement required
• Strong computer skills
• Excellent written and verbal communication skills
• Excellent interpersonal and organizational skills

Working Conditions/Physical Demand

Business Office Environment within a fast paced department with phone and computer use

Working indoors with client/customer contact needed via telephone communication

What You’ll Love About Working Here

• A team that supports you — Work in a collaborative, encouraging environment where your contributions are valued.
• Room to grow — Access meaningful growth and development opportunities that help you build your career.
• Work with purpose — Play a key role in ensuring patients receive the coverage and care they depend on.
• Benefits that care for you — Enjoy comprehensive benefits designed to support your well‑being at work and at home.

Pay

In compliance with New Jersey's Pay Transparency Act, the compensation range for this position is USD $16.00 to USD $24.00. When determining an offer, VNA Health Group considers factors such as the scope and responsibilities of the role, the candidate's work experience, education/training, relevant skills, internal pay equity, and market and organizational conditions.