About this role
Clinical Reimbursement Specialist
Monmouth County, New Jersey
Type
Full Time
We're Hiring: Clinical Reimbursement Specialist!
Support Care. Strengthen Access. Make a Real Impact.
The Visiting Nurse Association Health Group (VNAHG) is a mission‑driven nonprofit that has been trusted by New Jersey families for more than 110 years. Our team delivers a wide range of services, including home health, rehabilitation, hospice, and community‑based care, so individuals can receive the support they need where they feel most comfortable. Joining VNAHG means contributing to a mission that puts people first and strengthens the health of our communities.
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 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.
Working Conditions/Physical Demand: Working indoors with client/customer contact needed via telephone communication