The Benefits & Authorizations Clerk ensures accurate and timely benefits information and authorizations for employees and clients, managing claims, verifying eligibility, and coordinating with departments and external providers.
Responsibilities
Process and verify employee benefits claims and authorizations in accordance with company policies and regulatory requirements.
Maintain accurate records of benefits usage, authorizations, and communications with employees and external providers.
Coordinate with insurance companies, healthcare providers, and internal departments to resolve issues related to benefits coverage and authorizations.
Respond promptly to employee inquiries regarding benefits status, eligibility, and claim procedures.
Ensure compliance with all relevant laws, regulations, and company policies related to benefits administration.
Requirements
High school diploma or equivalent
Associate degree or higher
Nice to have: Healthcare or insurance environment
Nice to have: Federal and state regulations governing employee benefits
Nice to have: Certification related to benefits administration (e.g., CEBS)
Lead security architecture and technical authorization readiness for Nominal’s classified deployments, focusing on Special Access Program environments.
Responsibilities
Define security architectures and technical requirements for classified deployments, including SAP environments and other highly restricted customer environments.
Translate customer security requirements, NIST 800-53 controls, applicable CNSSI overlays, STIGs, and program-specific constraints into actionable engineering requirements and implementation plans.
Partner with engineering teams to design and validate security controls across infrastructure, network boundaries, identity and access management, data flows, software delivery, logging, and system monitoring.
Lead resolution of technical security challenges that could impede classified deployments, working directly with customer security stakeholders and internal engineering teams.
Drive technical authorization readiness, including System Security Plan content, architecture diagrams, control narratives, supporting evidence, and other artifacts required for ATO packages.
As a key member of the Northpoint team, the Utilization Review Coordinator supports Northpoint’s Utilization Review (UR) function by coordinating the administrative and operational components of the authorization process and providing direct support to Utilization Review Specialists across assigned markets.
Monitor authorization work queues, fax queues, and tracking tools to assist with the management of pending, approved, denied, and expiring authorizations.
Track authorization dates, approved units/days, expiration dates, payer reference numbers, and other required authorization information.
Proactively identify upcoming authorization expirations and communicate deadlines or outstanding requirements to the appropriate UR Specialist.
Coordinate the timely collection and submission of clinical documentation required by payers, including progress notes, treatment plans, assessments, discharge summaries, and other requested records.
Upload, fax, electronically transmit, or submit clinical documentation through designated payer portals and verify successful receipts.
Requirements
High school diploma or equivalent
associate or bachelor’s degree in healthcare administration, behavioral health, business administration, health information management, or related field
Nice to have: experience in behavioral health
Nice to have: experience in revenue cycle management
Insurance Verification Representative - Tennova Gastroenterology - Turkey Creek
The Insurance Verification Representative verifies insurance coverage and benefits for scheduled procedures and services, ensuring accurate patient records and facilitating timely reimbursement.
Responsibilities
Verifies patient insurance information, including eligibility, benefits, and coverage limitations.
Reviews scheduled services and procedures to determine any necessary pre-certifications or authorizations.
Coordinates with insurance providers to obtain required authorizations and verifies prior approvals.
Communicates insurance requirements and benefit information to patients and answers any questions related to coverage.
Accurately enters and updates insurance information in the patient’s medical record and billing systems.
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