Verification Specialist

Easterseals New Jersey • Jamesburg, NJ

33d • Remote

About The Position

Verification Specialist – Jamesburg, NJ (Remote) Shift: Part-Time, Saturday & Sunday 8 AM to 6 PM Join Our Team – Make a Difference! Are you passionate about supporting individuals with developmental disabilities and mental health challenges? Join a dynamic team dedicated to improving lives! About Us and Our Program: Easterseals, a national nonprofit, has supported individuals with disabilities for over 50 years. Its Agency with Choice program offers an alternative to traditional provider-managed services, empowering participants to manage their support and services with increased choice and authority. What You’ll Do: The Verification Specialist will review and analyze case notes to ensure that the services rendered comply with the program participant’s Plan of Care (POC) for Medicaid billing purposes.

Requirements

• Associate’s degree preferred.
• 1 year of previous experience in data/insurance verification.
• Proficient in Medicaid billing procedures, intermediate MS Office skills, and strong typing abilities with experience in transcribing notes for data entry into applications and systems.
• Strong verbal communication skills (Spanish preferred)
• Exceptional customer service and relationship management abilities
• Detail-oriented
• Highly skilled in time management

Responsibilities

• Research, investigate, and follow-up with the self-directed employees (SDEs) and Program Participants to effectively resolve discrepancies impacting payments to providers and Medicaid billing.
• Reviews SDE case notes and timesheets to ensure accuracy of information, continuity of care, and appropriateness & timeliness of documentation in accordance with Medicaid’s billing requirements.
• Contacts SDEs when notes are not consistent with the set requirements, standards, and POC.
• Collaborates/Communicates with Verification Team Lead on any information received from Authorized Representatives, Support Coordinators, or SDEs regarding the participant’s care or needs.
• Researches, investigates, and follows-up with program participants to effectively resolve any discrepancies, which may have an impact on payments made to providers as well as Medicaid billings.
• Coordinates referrals for prior authorization and services covered.

Benefits

• Competitive Pay & Benefits – Including Medical, Dental, Vision, and Flexible Spending Accounts
• Employer-Paid Coverage – Life, AD&D, and Long-Term Disability Insurance
• Retirement Savings – 403(b) Plan with Employer Match
• Generous Time Off – Paid Time Off, Holidays, Medical Leave, and PTO Buy-Back options
• Convenience & Support – Direct Deposit, Payroll Cards, and Employee Assistance Program
• Wellness & Recognition – Wellness Program, Referral Bonuses, and a Recognition Program
• Training & Development – Paid Orientation and Ongoing Training

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: Associate degree