Authorization & Referrals Specialist II #Full Time

servcorphr; New York (NY); On-site; USD 34,000 - 46,000; Full time

Benefits offered by this job

Healthcare

Paid Time Off

Competitive benefits package

Job summary

61st Street Service Corporation, providing administrative and clinical support for ColumbiaDoctors in the Northeast, seeks an Authorization-Referrals Specialist II. You will ensure proper authorizations for specialty services and office visits, liaising between patients, referring and primary providers, and care teams.

Responsibilities include clearing authorizations, confirming insurance coverage, obtaining approvals, processing referrals, and supporting patient access while handling routine

Qualifications

• High school diploma or GED required.
• Experience in physician billing or third-party payer environment desired (minimum 1 year).
• Knowledge of contracts, insurance benefits, benefits exclusions and billing requirements is required.
• Familiarity with payer adjudication process and claim forms preferred.

Responsibilities

• Ensure patients have been authorized for specialty services and office visits.
• Resolve authorization concerns before patient appointments.
• Confirm insurance coverage status for patients.
• Obtain authorizations from insurance providers when needed.
• Process preauthorization forms for requested physician office or provider.
• Process patient referrals and link referrals to identified visits.
• Assist patients in obtaining appropriate physician, hospital, and medical referrals.
• Perform administrative duties including answering phones and greeting patients.
• Perform related duties as assigned.

Skills

Microsoft Word

Microsoft Excel

Outlook

Email

Education

High School Diploma or GED

Tools

Epic

Job description

Top Healthcare Provider Network

The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors’ practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties.

Job Summary:

The Authorization-Referrals Specialist II is responsible to ensure that patients have been authorized for specialty services and office visits. May act as a liaison between the patient provider/referring provider, primary care provider, and other parties involved in the plan of care. Appropriately link referrals for identified visits.

Job Responsibilities:

• Ensure patients have been cleared for specialty services and office visits.
• Resolve authorization concerns prior to any patient's appointment.
• Confirm insurance coverage or lack thereof for patient.
• Obtain authorizations if needed from insurance coverage.
• Process preauthorization forms for requesting physician office or provider.
• Process patient referrals and link referrals for identified visits.
• Assist patient in gaining appropriate physician, hospital, and medical referrals.
• Perform administrative duties, including answering telephones and greeting patients.
• Perform related duties as assigned.

Job Requirements:

• High school graduate or GED certificate is required.
• A minimum of 1 years’ experience in a physician billing or third-party payer environment.
• Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.
• Candidate must demonstrate the ability to understand and navigate the payer adjudication process.
• Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.).
• Patient financial and practice management system experience in Epic and or other of electronic billing systems is preferred.
• Knowledge of medical terminology is preferred.
• Previous experience in an academic healthcare setting is preferred.

Hourly Rate Ranges: $24.76 - $33.17

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.