Healthcare Pre-Authorization Specialist

BronxCare Health System; New York (NY); Sur place; USD 48 000 - 64 000; Plein temps

Résumé du poste

BronxCare Health System is seeking a Pre-Authorization Specialist to ensure timely processing of pre-authorizations for medical and ancillary services. You will work daily with practice managers, clinicians, and staff to confirm visits are properly registered and compliant with insurance requirements, while supporting CQI and risk management efforts.

The role requires strong customer service, solid computer skills, and experience in hospital billing or insurance verification.

Qualifications

• Two years of hospital/healthcare experience in financial investigations, insurance verification, or authorization.
• High school diploma or GED.
• Associates degree.

Responsabilités

• Obtain and process pre-authorization, authorization, and pre-certification requests for medical and ancillary services.
• Establish and maintain positive relationships with patients, visitors, and staff.
• Respond to inquiries from practice managers, clinicians, and PFS staff to ensure visits are properly registered and authorized.
• Navigate Allscripts EMR and retrieve required utilization data to facilitate insurance carrier review and expeditious approval.
• Maintain reporting on productivity and outstanding items; follow up on open cases as needed.

Connaissances

Customer service

Communication

Attention to detail

Formation

High School or GED

Associate's degree

Outils

Allscripts EMR

Description du poste

BronxCare Health System is seeking a Pre-Authorization Specialist to ensure timely processing of pre-authorizations for medical and ancillary services. You will work daily with practice managers, clinicians, and staff to confirm visits are properly registered and compliant with insurance requirements, while supporting CQI and risk management efforts.

The role requires strong customer service, solid computer skills, and experience in hospital billing or insurance verification.