Social insurance administrator full time jobs

Job Description About the Role: The Insurance Precert Representative at Wooster Community Hospital plays a critical role in ensuring that patients receive timely and appropriate healthcare services by managing the precertification process with insurance providers. This position involves verifying insurance coverage, obtaining necessary authorizations, and communicating effectively with both healthcare teams and insurance companies to facilitate smooth patient care delivery. The representative acts as a liaison to reduce delays in treatment by proactively addressing insurance requirements and resolving any issues related to coverage. Accuracy and attention to detail are paramount, as the role directly impacts hospital revenue cycle and patient satisfaction. Ultimately, this position supports the hospital's mission by ensuring compliance with insurance policies while enabling patients to access the care they need without unnecessary administrative barriers. Minimum Qualifications: High school diploma or equivalent required; associate degree or higher preferred. Experience working with health insurance policies, preferably in a healthcare or hospital setting. Strong knowledge of medical terminology and healthcare billing processes. Proficiency in using electronic health records (EHR) and insurance verification software. Excellent communication and organizational skills. Preferred Qualifications: Prior experience specifically in precertification Familiarity with multiple insurance providers and their authorization procedures. Ability to handle multiple tasks efficiently in a fast-paced healthcare environment. Advanced computer skills including Microsoft Office Suite and database management. Responsibilities: Review and verify patient insurance information to determine coverage and precertification requirements. Initiate and follow up on precertification requests with insurance companies to obtain necessary authorizations for medical procedures and services. Maintain detailed and accurate records of all precertification activities and communications in the hospital's information systems. Collaborate with clinical staff, billing departments, and insurance representatives to resolve any issues or discrepancies related to insurance coverage. Monitor and track authorization status to ensure timely completion and communicate updates to relevant hospital departments and patients as needed. Skills: The Insurance Precert Representative utilizes strong communication skills daily to interact with insurance companies, healthcare providers, and patients, ensuring clear and effective information exchange. Analytical skills are essential for reviewing insurance policies and medical documentation to determine precertification requirements accurately. Organizational skills help manage multiple authorization requests simultaneously while maintaining detailed records to support compliance and billing accuracy. Problem-solving abilities are frequently applied to resolve coverage issues or discrepancies that could delay patient care. Additionally, proficiency with healthcare software systems enables efficient tracking and documentation of all precertification activities, contributing to streamlined hospital operations and improved patient outcomes. M-F 830-5 40 hours per week

Monday-Thursday 8:00am-5:00pm, Friday 8:00am-12:00pm Full Time/36-Hour Week Akron Campus Center for Dental Health Summa Health System is recognized as one of the region's top employers by a number of third party organizations, including NorthCoast 99. Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and competitive pay and benefits. Summary: This position serves as a liaison between the Dental Clinic providers, including residents, and payers, the hospital, and patients. This role's responsibilities include hospital and payer privileging, credentialing and enrollment, to ensure compliant revenue cycle activities. Additionally, this role serves as the gatekeeper for payer information and maintains accurate records and repositories of effective dates, contracted payers, and plan information.. Formal Education Required: * High school diploma or equivalent. * Associate degree preferred Experience & Training Required: * Three (3) years' experience in provider credentialing, managed care, physician office, and/or other healthcare-related environment to include experience with dental insurance verification, front-desk registration duties or related medical office roles, and experience working with an Electronic Health Record (EHR) system preferred. * Working knowledge of dental/medical billing procedures, computers, calculators, and other equipment used in Financial Services. Other Skills, Competencies and Qualifications: * Knowledge of medical or dental terminology and CDT codes. * Demonstrated understanding of the variations in insurance plans and requirements. * Ability to solve practical problems, interpret a variety of instructions furnished in written, oral, diagram or schedule form and to work reliably and with professionalism in a high-volume, high demand medical environment. * Proficiency in Microsoft Word, Microsoft Excel, and e-mail. Prefer skills in using health plan web sites. * Excellent organizational and communication skills. * Ability to work independently and productively as part of a team to reach decisions and solve problems * Good analytical skills necessary for problem solving. * Ability to maintain confidentiality of patient, employee, and financial information. * Ability to interact with populations of patients with an understanding for their needs of self-respect and dignity. Level of Physical Demand: * Sedentary: Exerts up to ten pounds of force occasionally and/or a negligible amount of force frequently. Equal Opportunity Employer/Veterans/Disabled $22.61/hr - $27.14/hr The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical. Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits. * Basic Life and Accidental Death & Dismemberment (AD&D) * Supplemental Life and AD&D * Dependent Life Insurance * Short-Term and Long-Term Disability * Accident Insurance, Hospital Indemnity, and Critical Illness * Retirement Savings Plan * Flexible Spending Accounts - Healthcare and Dependent Care * Employee Assistance Program (EAP) * Identity Theft Protection * Pet Insurance * Education Assistance * Daily Pay

Monday-Thursday 8:00am-5:00pm, Friday 8:00am-12:00pm Full Time/36-Hour Week Akron Campus Center for Dental Health Summa Health System is recognized as one of the region's top employers by a number of third party organizations, including NorthCoast 99. Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and competitive pay and benefits. Summary: This position serves as a liaison between the Dental Clinic providers, including residents, and payers, the hospital, and patients. This role's responsibilities include hospital and payer privileging, credentialing and enrollment, to ensure compliant revenue cycle activities. Additionally, this role serves as the gatekeeper for payer information and maintains accurate records and repositories of effective dates, contracted payers, and plan information.. Formal Education Required: * High school diploma or equivalent. * Associate degree preferred Experience & Training Required: * Three (3) years' experience in provider credentialing, managed care, physician office, and/or other healthcare-related environment to include experience with dental insurance verification, front-desk registration duties or related medical office roles, and experience working with an Electronic Health Record (EHR) system preferred. * Working knowledge of dental/medical billing procedures, computers, calculators, and other equipment used in Financial Services. Other Skills, Competencies and Qualifications: * Knowledge of medical or dental terminology and CDT codes. * Demonstrated understanding of the variations in insurance plans and requirements. * Ability to solve practical problems, interpret a variety of instructions furnished in written, oral, diagram or schedule form and to work reliably and with professionalism in a high-volume, high demand medical environment. * Proficiency in Microsoft Word, Microsoft Excel, and e-mail. Prefer skills in using health plan web sites. * Excellent organizational and communication skills. * Ability to work independently and productively as part of a team to reach decisions and solve problems * Good analytical skills necessary for problem solving. * Ability to maintain confidentiality of patient, employee, and financial information. * Ability to interact with populations of patients with an understanding for their needs of self-respect and dignity. Level of Physical Demand: * Sedentary: Exerts up to ten pounds of force occasionally and/or a negligible amount of force frequently. Equal Opportunity Employer/Veterans/Disabled $22.61/hr - $27.14/hr The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical. Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits. * Basic Life and Accidental Death & Dismemberment (AD&D) * Supplemental Life and AD&D * Dependent Life Insurance * Short-Term and Long-Term Disability * Accident Insurance, Hospital Indemnity, and Critical Illness * Retirement Savings Plan * Flexible Spending Accounts - Healthcare and Dependent Care * Employee Assistance Program (EAP) * Identity Theft Protection * Pet Insurance * Education Assistance * Daily Pay