Glens Falls Hospital-posted 9 days ago
$18 - $27/Yr
Full-time • Entry Level
Saratoga Springs, NY
5,001-10,000 employees

The Impact You Can Make Team Impact The Referral and Authorization Specialist is responsible for obtaining authorizations as required from providers and payers to ensure all reimbursement requirements are met The Glens Falls Hospital Impact Mission Our Mission is to improve the health of people in our region by providing access to exceptional, affordable, and patient-centered care every day and in every setting. How You Will Fulfill Your Potential Responsibilities Verify patient insurance eligibility & coordination of benefits. Prepare and compile necessary documentation to secure prior authorization. Collect clinical information regarding service to be rendered as applicable (J codes, CPT codes, ICD codes, Units) as well as medical records. Interviews patients to apprise them of their insurance benefits contingent on the type of procedure / level of care to secure collection of patient financial obligations / secure payment arrangements Contact provider / payer to obtain prior authorization. Gather additional clinical and / or coding information as necessary in order to obtain prior authorization Verify via website or telephone that the authorization number(s) provided by providers are correct, that the location authorized is appropriate for the patients encounter and location,and verify validity dates. Ensure that services ordered are within benefit plan and approved for procedure / testing point of service as appropriate

  • Verify patient insurance eligibility & coordination of benefits.
  • Prepare and compile necessary documentation to secure prior authorization.
  • Collect clinical information regarding service to be rendered as applicable (J codes, CPT codes, ICD codes, Units) as well as medical records.
  • Interviews patients to apprise them of their insurance benefits contingent on the type of procedure / level of care to secure collection of patient financial obligations / secure payment arrangements
  • Contact provider / payer to obtain prior authorization.
  • Gather additional clinical and / or coding information as necessary in order to obtain prior authorization
  • Verify via website or telephone that the authorization number(s) provided by providers are correct, that the location authorized is appropriate for the patients encounter and location,and verify validity dates.
  • Ensure that services ordered are within benefit plan and approved for procedure / testing point of service as appropriate
  • High School Diploma or Equivalent
  • Ability to type 60 WPM
  • Ability to multitask and meet deadlines
  • Ability to problem solve and work independently
  • Strong organizational skills, effective interpersonal skills
  • Associates Degree or four (4) years of insurance experience in a healthcare environment preferred
  • Knowledge of CPT and ICD coding desired
  • Knowledge of Medicare and third party payer regulations desired
  • Glens Falls Hospital is committed to providing our people with valuable and competitive benefits offerings, as it is a core part of providing a strong overall employee experience. A summary of these offerings, which are available to active, full-time and part-time employees who work at least 30 hours per week, can be found here .
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