Authorization Specialist I - CMH

Albany Medical Center • Catskill, NY

7d • $49,763 - $69,668 • Onsite

About The Position

The Patient Engagement Authorization Specialist I (IAS II) is responsible for financially securing Ambulatory, Ancillary, Surgical and Procedural services. This includes securing Referral and Authorization, Insurance Verification and Benefit interpretation to discern insurance guidelines are being adhered to. The ability to interact with patients and stakeholders for successful financial clearance is critical for compliance with authorization and referral guidelines. This position requires the ability to work in a high-volume, fast-paced environment. Understanding of complex scheduling needs of our patients in an empathetic, compassionate manner is critical. The position requires the use of eligibility application and authorization portals to invoke requests to verify insurance eligibility, interpret responses, and capture appropriate health insurance information as it pertains to the service being rendered. The position requires the ability to understand and apply contractual benefits to the service being rendered, with the ability to collect patient financial obligations pre-services.

Requirements

• Associates Degree
• CHAA (or acquired within 2 years of hire)
• Winning customer service personality with ability to engage patients, provider and provider staff as well as insurance company representatives via telephone with superior patient experience.
• Strong insurance knowledge specific to complex scheduling needs and authorization management
• Proven customer service skill with ability to exceed expectations
• Demonstrated knowledge payer authorization requirements
• Strong attention to detail
• Ability to multi-task in stressful and high patient volume unit
• Must be able to manage pressure of very tight timeframes to execute task
• Ability to learn in classroom, utilizing resources
• Ability to remain composure under pressure
• Ability to train and onboard colleague
• Ability to review information and draw appropriate conclusion
• Good judgement and ability to be resourceful to problem solve; escalate issues as needed
• Team minded worth ethic
• Demonstrated ability interpret patient’s insurance benefits and apply the applicable contractual obligations
• Critical thinking ability regarding issues with financially securing payment

Nice To Haves

• Bachelor Degree preferred
• 3 – 5 years’ experience in Hospital or Physician office experience or call center environment, preferred

Responsibilities

• Financially securing Ambulatory, Ancillary, Surgical and Procedural services.
• Securing Referral and Authorization.
• Performing Insurance Verification and Benefit interpretation.
• Interacting with patients and stakeholders for successful financial clearance.
• Using eligibility application and authorization portals to verify insurance eligibility.
• Interpreting insurance eligibility responses.
• Capturing appropriate health insurance information.
• Understanding and applying contractual benefits to services.
• Collecting patient financial obligations pre-services.

Benefits

• Excellent health care coverage with no copay at Albany Medical Center providers
• A wide array of services and programs to support emotional, physical, and mental wellbeing

What This Job Offers

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