Medical Billing & Pre-Auth Specialist

Upstate; City of Syracuse (NY); On-site; USD 52,000 - 73,000; Full time

Job summary

State University of New York Upstate Medical University is seeking a Billing/Coding Analyst to ensure proper ABN waivers, pre-authorizations, referrals, and demographic accuracy before exams are ordered.

The role involves auditing, reviewing insurance denials, providing ICD-10 coding, and monitoring regulatory changes across hospital and MSG to optimize operations.

You will interact with physicians, patients, and staff to obtain complete information at scheduling or prior to order.

Qualifications

• Associates degree and 2 years’ administrative experience in a medical setting.
• Training in Medical Terminology, Medical Coding, or Medical Assistant program.
• Knowledge of ICD-10, CPT coding principles preferred.

Responsibilities

• Analyze OP admits for ABN waivers, pre-authorizations, referrals and demographics.
• Interact with referring physicians, patients, hospital and MSG staff to obtain scheduling information.
• Assist with pre-authorization and pre-registration requirements.
• Conduct internal audits and maintain documentation.
• Review insurance denials and coordinate corrective actions.
• Review orders for clinical indications and provide ICD-10 coding.
• Monitor billing/compliance regulations for Hospital and MSG.

Skills

Administrative experience

Medical terminology

Medical coding

Billing knowledge

Education

Associate degree

Job description

State University of New York Upstate Medical University is seeking a Billing/Coding Analyst to ensure proper ABN waivers, pre-authorizations, referrals, and demographic accuracy before exams are ordered.

The role involves auditing, reviewing insurance denials, providing ICD-10 coding, and monitoring regulatory changes across hospital and MSG to optimize operations.

You will interact with physicians, patients, and staff to obtain complete information at scheduling or prior to order.