Medical Authorization & Revenue Integrity Specialist

BronxCare Health System; New York (NY); On-site; USD 42,000 - 54,000; Full time

Job summary

BronxCare Health System is seeking a diligent authorization coordinator to manage pre-authorizations for medical and ancillary services. The role requires daily collaboration with practice managers, clinicians, and staff to ensure accurate registration and compliance with insurance requirements.

The position involves reviewing utilization data, updating staff on authorization decisions, and using Allscripts EMR to support timely approvals.

Qualifications

• Minimum two years’ hospital/healthcare experience in financial investigations and/or insurance verification and/or insurance authorization.
• Excellent customer service skills are required.
• High school diploma or GED is required.
• Associates degree preferred.
• Basic computer knowledge is expected.

Responsibilities

• Establish and maintain positive relationships with patients, visitors, and staff.
• Ensure pre-authorizations for medical and ancillary services are obtained timely.
• Communicate with practice managers, clinicians and registration staff daily.
• Navigate Allscripts EMR to retrieve clinical utilization data for authorization.
• Support CQI activities and ensure compliance with safety and privacy policies.

Skills

Excellent Customer Service Skills

Basic Computer Knowledge

Education

High School or GED

Associates

Job description

BronxCare Health System is seeking a diligent authorization coordinator to manage pre-authorizations for medical and ancillary services. The role requires daily collaboration with practice managers, clinicians, and staff to ensure accurate registration and compliance with insurance requirements.

The position involves reviewing utilization data, updating staff on authorization decisions, and using Allscripts EMR to support timely approvals.