Insurance Specialist

2200 The Winifred Masterson Burke Rehabilitation Hospital; United States; On-site; USD 39,000 - 43,000; Full time

Benefits offered by this job

Medical Coverage

Dental Coverage

Generous Paid Time Off

403B Retirement Plan with matching

Job summary

Burke Rehabilitation Hospital in White Plains, NY, is seeking an Admitting Scheduling professional for day shifts, Mon-Fri, 8:30 AM–4:30 PM. The role manages insurance authorizations and Medicare/Medicaid workflows for OPD and off-site services, ensuring compliance and timely follow-ups.

The ideal candidate has 3–5 years of hospital or insurance experience, strong communication skills, and proficiency with scheduling systems.

Qualifications

• High School Diploma or GED required.
• 3-5 years in hospital/outpatient or insurance environments preferred.
• Computer literacy and familiarity with scheduling systems required.
• Knowledge of medical terminology is required.
• Experience obtaining insurance authorizations or referrals is required.
• Able to work independently and meet deadlines for authorizations.

Responsibilities

• Advises patients of insurance coverage and potential out of pocket expenses.
• Notifies departments and patient accounts when insurance stops covering treatment.
• Follow Medicare guidelines for outpatient rehabilitation for off-sites and OPD Medicare patients.
• Track Medicare patients nearing benefit exhaustion.
• Distribute ABN’s to off-site and OPD Medicare patients when limits are met.
• Follow Medicaid guidelines for outpatient rehab and obtain daily authorizations.
• Answer patient phone inquiries.
• Review outpatient business office mail.
• Update Mediserve authorization file with authorizations.
• Schedule re-evaluation appointments for insurance follow-up.
• Maintain follow-up system for case managed accounts.
• Notify patients if their carrier has not pre-authorized OPD services.
• Contact patients to obtain updated prescriptions if necessary.
• Contact physician offices for updated prescriptions if necessary.
• Follow-up with insurers on pending authorizations.
• Provide OPD case management as needed.
• Backup coverage to schedulers in OPD and satellites as needed.

Skills

Computer literacy

Organization

Customer service

Attention to detail

Multitasking

Medical terminology

Scheduling systems

Independence

Communication

Initiative

Education

High School Diploma or GED

3-5 years hospital/insurance experience

Job description

Location & Shift

City/State: White Plains, New York

Department: Admitting Scheduling

Work Shift: Day

Work Days: MON-FRI

Scheduled Hours: 8:30 AM-4:30 PM

Scheduled Daily Hours: 7 HOURS

Hourly Rate/Range: $28.00-$31.00

Sign-On Bonus: n/a (For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.)

Job Summary

Responsibilities include case management for all commercial insurance, Medicare and Medicaid primarily for off-sites and OPD as needed.

Essential Functions

• Advises patients of insurance coverage and potential out of pocket expenses
• Notifies clinical departments and patient accounts when insurance will no longer cover treatment
• Responsible for following Medicare guidelines for outpatient rehabilitation for off-sites and OPD Medicare patients
• Responsible for tracking when Medicare patients are close to exhausting their rehabilitation benefit
• Distributing ABN’s to off-site and OPD Medicare patients when patients meet rehabilitation benefit limits
• Responsible for following Medicaid guidelines for outpatient rehabilitation and obtaining daily authorizations for off-site and OPD Medicaid patients
• Answer patient phone inquiries
• Responsible for review of all Outpatient Business Office mail
• Update Mediserve authorization file with authorizations
• Schedules re-evaluation appointments for insurance follow-up
• Responsible for setting up and maintaining follow-up system for case managed accounts for initial and recurring authorization requests
• Responsible for notifying patients if their carrier has not pre-authorized OPD services and advising patient of Burke payment policies
• Contact patients to obtain updated prescriptions if necessary
• Contact physician offices to obtain additional updated prescriptions if necessary
• Responsible for follow-up calls to insurance companies on pending authorizations
• Responsible for OPD case management as needed
• Will provide back up coverage to schedulers in OPD as needed, and the satellites on an emergency basis
• Any other duty as directed by Manager
• Practices universal precautions
• Demonstrates the ability to communicate with pediatric, adolescent, young adult and geriatric patients and visitors
• Adheres to Service Excellence Standards by demonstrating positive communication, prompt & respectful service and maintaining an appropriate work environment when working with patients, staff, co-workers, visitors and others
• Other duties as assigned

Qualifications

• High School Diploma or GED Required
• 3-5 years in hospital setting (preferable outpatient), billing company, multi specialty doctor’s office or insurance company Required
• Individual must be computer literate, possess excellent organizational and customer service skills, detail oriented and able to multi task
• Knowledge of medical terminology is required
• Prior experience obtaining insurance authorizations or referrals is required
• Computer experience required, preferably working with a scheduling system
• Able to work independently and to meet insurance authorization expiration date deadlines
• Must be able to communicate with tact and diplomacy
• Takes initiative and be self-directed

Equal Employment Opportunity

The Burke Rehabilitation Hospital is an equal employment opportunity employer. The Burke Rehabilitation Hospital will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.

Culture & Values

At Burke, we all share the same passion – to help our patients recover as fully as possible.

We welcome you to share your particular talents and expertise by exploring our available positions. Return often, as we update our postings frequently.

Burke, a member of the Montefiore Health System, is a not-for-profit provider of Physical Medicine and Rehabilitation care. Burke’s flagship hospital and main campus are centrally located in White Plains, NY. Burke operates an expanding network of outpatient therapy clinics in Westchester County and the Bronx, NY. Burke offers career opportunities in all areas of patient care and hospital operations.

Employee Experience

• A culture of mentorship and collaboration
• Working with an inter-disciplinary team of experts
• Clinical knowledge growth through regular in-services and other opportunities
• Career growth within the organization
• Providing patient-centered care using state of the art equipment
• Earning extremely high patient satisfaction scores
• Ensuring a great reputation in our local communities
• Giving back through volunteering at Burke-sponsored events
• Recognition for their contributions at the local and national level

Benefits Package

• Medical Coverage
• Dental Coverage
• Generous Paid Time Off
• A 403B Retirement Plan with matching contributions
• An Employee Assistance Program ("EAP") – free for employees and dependents
• Medical and Dependent Flexible Spending Accounts
• Short-term Disability and New York Paid Family Leave Insurance
• Long-term Disability Insurance
• Life and AD&D Insurance
• Voluntary Insurances at group rates: Life, AD&D, enhanced Short Term Disability, Vision, Pet Tuition Reimbursement Program Employee Fitness Center Free parking (most locations)