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Job Summary :
The Authorization-Referrals Specialist II is responsible for verifying insurance policy benefit information, and securing payer required referrals and authorizations.
This position is responsible for obtaining accurate and timely pre-authorizations for professional services prior to the patient's visit, scheduled admission, or immediately following hospital admission.
Prior authorizations may include, but are not limited to surgical procedures, outpatient treatments, medications and diagnostic testing (i.
e. ultrasounds, labs, radiology, IV therapy, referrals).
Multi-site coverage in the Westchester area may be needed.
Job Responsibilities : Verify insurance coverage and update any changes in the billing system.Confirm provider's participation status with patient's insurance plan / network.
Determine payer referral and authorization requirements for professional services.Contact patient and PCP to secure payer required referral for planned services.
Initiate authorization and submits clinical documentation as requested.Follow through on pre-certifications until final approval is obtained.
Manage faxes, emails, and phone calls.Communicate with surgical coordinators regarding authorizations status or denials.Submit appeals in the event of denial of prior authorizations or denial of payment.
Assists Supervisor with special projects and / or tasks.Assists Authorization-Referrals Specialist I with complex cases or questions.
Serves as back-up to Authorization-Referrals Specialist III.Performs other job duties as assigned.Job Qualifications :
High school graduate or GED certificate is required.A minimum of 1-year experience in a physician's billing or third payer environment.
Candidate must demonstrate the ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations.
Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)Functional proficiency and comprehension of medical terminology.
Experience in Epic and or other of electronic billing systems is preferred.Knowledge of medical terminology, diagnosis and procedure coding is preferred.
Previous experience in an academic healthcare setting is preferred.
Hourly Rate Ranges : $22.78 - $30.77
Note : Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.
61st Street Service Corporation
At 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees.
The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.
We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.
Last updated : 2024-05-31
Full Time
$66k-81k (estimate)
04/26/2024
06/02/2024
mediabistro.com
New York, NY
100 - 200
The job skills required for Authorization specialist include Customer Service, Billing, Prior Authorization, etc. Having related job skills and expertise will give you an advantage when applying to be an Authorization specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Authorization specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Authorization specialist positions, which can be used as a reference in future career path planning. As an Authorization specialist, it can be promoted into senior positions as a Medical Policy Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Authorization specialist. You can explore the career advancement for an Authorization specialist below and select your interested title to get hiring information.
If you are interested in becoming an Authorization Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become an Authorization Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Authorization Specialist job description and responsibilities
Updates patient insurance and demographics information as needed.
03/31/2022: Florence, SC
Request, follow up and secure prior-authorizations prior to services being performed.
03/30/2022: Rochester, NY
Complete authorizations and referrals for services, including appointments and procedures.
01/29/2022: Clarksville, TN
Monitors incoming patient orders and gathers information needed to complete the pre-authorization and scheduling of an order
03/22/2022: Ann Arbor, MI
Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
01/29/2022: York, PA
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Authorization Specialist jobs
There are great benefits to having a Prior Authorization Certified Specialist on staff to help with the administrative process.
03/31/2022: Greensboro, NC
Give credence to customer complaints.
02/08/2022: Salem, OR
Create a quick reference guide of your payor contacts
04/11/2022: Cincinnati, OH
Authorization Specialist assist with other clerical tasks as needed.
01/22/2022: Lincoln, NE
Licenses and certifications are not usually required to work as a prior authorization specialist.
03/09/2022: Bremerton, WA
Step 3: View the best colleges and universities for Authorization Specialist.