Pre-Authorization Specialist

Weill Cornell Medical College • New York, NY

1d • $35 - $38 • Onsite

About The Position

Under direction, is responsible for the management of insurance verifications, eligibility and benefits, and prior authorizations for services provided. Serves as liaison between junior pre-Authorization staff and department leadership.

Requirements

• High School Diploma
• At least two (2) years prior related experience within the medical field.
• Demonstrated experience with insurance verifications, and pre-authorization procedures.

Responsibilities

• Verifies pre-authorizations and obtains upgrades if needed. If pre-authorization is not obtained for next day, notifies referring provider’s office and contacts patient to provide option to reschedule or sign a financial waiver of liability.
• Verifies patient insurance eligibility and obtains necessary pre-authorization numbers, if required, prior to appointment date.
• Facilitates the communication and collection of any fees due from patient.
• Ensures that provider participation database is updated as new insurance plans/products are identified during the verification/authorization process.
• Assists financial clearance and billing matters as needed, including but not limited to denial management WQs, CPT adjustments, research AR, and compliance.
• Assists with creation and implementation of department workflows, standards, and policies.
• Disseminates information to colleagues and/or staff as appropriate, including organized trainings for senior staff and new hires.
• Offers support to junior pre-authorization staff regarding patient inquiries, disputes, etc.
• Performs other related duties as directed.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED