Admin Asst-Insurance Authorization

Catholic Health; Village of Roslyn (NY); On-site; USD 34,440 - 48,216; Full time

Benefits offered by this job

Generous benefits packages

Tuition assistance

Defined benefit pension plan

Professional growth opportunities

Job summary

Catholic Health in the Village of Roslyn is looking for an experienced Authorization Specialist to ensure patients receive proper care through accurate authorizations. You'll be essential in processing requests and maintaining compliance with insurance requirements.

This role requires strong communication skills and a minimum of 3 years of healthcare experience. The position offers opportunities for professional growth and a supportive environment.

Qualifications

• Minimum of 3 years of relevant healthcare experience.
• Familiarity with third-party payer requirements for authorizations.
• Understanding of authorization processes across various payers.

Responsibilities

• Review and verify patient coverage and secure necessary authorizations.
• Process authorization requests focusing on accuracy.
• Track and document all communications with insurance carriers.
• Prioritize incoming authorization requests to maintain workflow.

Skills

CPT and ICD-10 coding knowledge

Strong written communication skills

Proficient in personal computers and software applications

Organizational skills

Critical thinking

Job description

Overview

St. Francis Hospital, The Heart Center® is New York State’s only specialty designated cardiac center. A member of Catholic Health, St. Francis is consistently recognized by U.S. News & World Report as a national leader for Cardiology & Heart Surgery, as well as for Gastroenterology & GI Surgery. Additionally, U.S. News rates St. Francis as high performing in Geriatrics, Neurology & Neurosurgery, Orthopedics, and Pulmonology. Nursing care at St. Francis is also nationally recognized, with multiple Magnet designations, as well as the AMSN PRISM Awards® and Beacon Awards. St. Francis has regularly out‑scored other hospitals on Long Island.

Job Details

We are seeking an experienced Authorization Specialist to join our cardiology office, where your expertise will play a crucial role in ensuring our patients receive the care they need seamlessly. This is an exciting opportunity to utilize your skills in obtaining accurate authorizations for various scheduled services, ensuring an efficient process that supports patient care and operational excellence.

Key Responsibilities

• Review & verify patient coverage, assess insurance coverage and secure necessary authorizations prior to provision of services, ensuring compliance with payer requirements.
• Process authorization requests for scheduled and add‑on procedures with focus on accuracy and speed.
• Maintain open communication, informing the team of challenges or delays in obtaining authorization.
• Track and document all communications with insurance carriers and facility representatives.
• Prioritize incoming authorization requests based on urgency to maintain workflow efficiency.
• Review documentation to ensure it meets medical policy guidelines to expedite approval.
• Obtain authorizations via payer websites or phone calls, following up on pending cases to achieve timely approvals.
• Inform department leadership about missed deadlines and elevate cases as necessary.
• Act as liaison between patient account services and physicians, creating daily work lists for daily operations.
• Support insurance and regulatory audits by providing relevant documentation.
• Analyze workflows to identify opportunities for improvement and reduction of denials.
• Collaborate with team, participate in projects, meet productivity standards, and contribute to meetings and committees.
• Provide backup support for check‑in processes and Epic patient access work queues as needed.

Position Requirements & Qualifications

• Proven knowledge of CPT and ICD‑10 coding, strong written communication skills.
• Familiarity with third‑party payer requirements for both in‑network and out‑of‑network authorization.
• Understanding of authorization processes across various payers.
• Coding certification is a plus but not mandatory.
• Minimum of 3 years of relevant healthcare experience.

Skills

• Proficient in personal computers and software applications such as word processing, spreadsheets, and databases.
• Excellent verbal and written communication, strong organizational skills, and aptitude for prioritizing assignments with minimal oversight.
• Professionalism and collaborative spirit; contributes positively to team environment.
• Strong critical thinking and clinical judgment, effective decision‑making.

Knowledge

• Stay updated on requirements from third‑party payers, regulatory agencies, and managed care entities regarding levels of care, continuity of benefits, and medical necessity guidelines.
• Awareness of managed care practices and latest trends in patient care.

Salary Range

USD $25.00 - $35.00 per hour (U.S. dollars). This range is a good‑faith estimate; actual pay includes bonuses, differential pay, and other compensations not included in this estimate. The salary range or rate listed does not include the value of benefits.

At Catholic Health, we believe in a people‑first approach. In addition to the estimated base pay, Catholic Health offers generous benefits packages, tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.