Authorization & Referrals Specialist III #Full Time #Remote

61st Street Service Corporation; New York, Northern (NY, KY); Hybrid; USD 60,000 - 77,000; Full time

Benefits offered by this job

Healthcare benefits

Paid time off

Remote work

Job summary

61st Street Service Corporation is seeking an Authorization & Referrals Specialist III. The role supports ColumbiaDoctors and is primarily remote, with residency required in the Tri-State area (NY/NJ/CT). You verify benefits, secure pre-authorizations, and assist with staff training and audits.

The position involves day-to-day management of referrals, authorizations, and billing processes to ensure timely patient care and compliant documentation. Competitive benefits offered.

Qualifications

• High school graduate or GED required.
• 2+ years in a physician billing or third-party payer environment.
• Ability to understand managed care eligibility and obtaining pre-authorizations.
• CPC certification preferred; Epic or similar billing systems experience preferred.

Responsibilities

• Verifies insurance coverage and payer requirements using system tools.
• Confirms provider participation with patient plans/networks.
• Determines referral and authorization requirements for services.
• Contacts patient and PCP to secure referrals for planned services.
• Documents referrals in the practice management system and submits paperwork.
• Manages faxes, emails, and phone calls promptly.
• Communicates with coordinators about authorizations status or denials.
• Submits appeals for denials and documents patient out-of-pocket estimates.

Skills

Insurance billing

Pre-authorization

Communication

Customer service

Education

High school diploma

CPC preferred

Tools

Epic

Payer portals

Job description

Career Opportunities with 61st Street Service Corp

Current job opportunities are posted here as they become available.

Authorization & Referrals Specialist III #Full Time #Remote

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.

This position is primarily remote, candidates must reside in the Tri-State area (New York, New Jersey, or Connecticut).

Job Summary:

The Authorization & Referrals Specialist III is responsible for verifying insurance policy benefit information, securing payer required referrals and authorization prior to the patient’s visit, scheduled admission, or immediately following hospital admission. This position is responsible for obtaining accurate and timely pre-authorizations for professional services. The Authorization-Referrals Specialist III is also responsible for assisting management with the daily work assignment, staff training, and quality audits.

Job Responsibilities:

• Verifies insurance coverage via system tools, payer portals .
• Confirms provider’s participation status with patient’s insurance plan/network.
• Determines payer referral and authorization requirements for professional services.
• Contacts patient and PCP to secure payer required referral for planned services.
• Documents referral in practice management system.
• Initiates authorization and submits clinical documentation as requested by insurance companies.
• Manage faxes, emails, and phone calls in a timely manner.
• Communicates with surgical coordinators regarding authorizations status or denials.
• Submits appeals in the event of denial of prior authorizations or denial of payment following procedures.
• Calculate and document patient out of pocket estimates and provide to patient.
• Assists Supervisor with special projects and/or tasks.
• Assists Authorization-Referrals Specialist I and II with complex cases pertaining to clearance of payer referrals, authorization or insurance eligibility issues.
• Assist supervisor/manager with distribution of daily work assignments.
• Assist with new-hire training and staff refresher training materials.
• Monitor and replenish the unit’s office supply needs.
• Performs other job duties as assigned.

Job Qualifications:

• High school graduate or GED certificate is required.
• A minimum of 2 years’ experience in a physician’s billing or third payer environment.
• Candidate must demonstrate the ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations.
• Certified Professional Coder certificate (CPC) is preferred.
• Experience in Epic and or other of electronic billing systems is preferred.
• Knowledge of medical terminology, diagnosis and procedure coding is preferred.
• Previous experience in an academic healthcare setting is preferred.

Hourly Rate Ranges: $28.72 - $36.92

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 61 st 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.