Pre-Authorization Representative

Weill Cornell Medicine; New York (NY); On-site; USD 32,000 - 35,000; Full time

Job summary

Weill Cornell Medicine on Upper East Side is seeking a Pre-Authorization Representative to manage insurance verifications, eligibility, and prior authorizations for referrals, surgeries, visits, or diagnostic testing.

The role is a non-exempt, full-time position with a 35-hour work week (Monday–Friday). The office emphasizes accurate verification, timely communication with physicians and patients, and efficient handling of pre-certifications.

Qualifications

• Demonstrated strong organizational skills.
• Ability to pay close attention to detail.

Responsibilities

• Verifies pre-certifications and obtains upgrades if needed.
• If pre-certification is not obtained for next day, notifies the referring doctor's office and contacts the patient to find out if they would rather reschedule.
• May greet patients in person and notify clinical staff of arrival.
• Verifies patient insurance eligibility and obtains necessary pre-authorization numbers prior to appointment date; facilitates collection of any fees due from patient.
• Initiates and prepares written correspondence as needed based on functional needs.

Skills

Organizational skills

Attention to detail

Education

High school diploma or GED

Job description

Title: Pre-Authorization Representative

Location: Upper East Side

Org Unit: Billing Support

Work Days: Monday-Friday

Weekly Hours: 35.00

Exemption Status: Non-Exempt

Salary Range: $23.30 - $25.27

*As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices

Position Summary

Under direction, is responsible for the management of insurance verifications, eligibility and prior authorizations for activities requiring referrals, which may include surgical procedures, visits and/or diagnostic testing

Job Responsibilities

• Verifies pre-certifications and obtains upgrades if needed. If pre-certification is not obtained for next day, notifies the referring doctor's office and contacts the patient to find out if they would rather reschedule.
• May be required to greet patients in person and notify clinical staff of arrival.
• Responsible for mail services, photocopying, scanning and filing.
• Verifies patient insurance eligibility and obtains necessary pre-authorization numbers, if required, prior to appointment date. Facilitates the communication and collection of any fees due from patient.
• Initiates and prepares written correspondence as needed and based on functional needs.

Education

• High school diploma or GED

Experience

Approximately 1 year of prior related experience in a customer service focused role.

Knowledge, Skills and Abilities

• Demonstrated strong organizational skills and ability to pay close attention to detail.

Licenses and Certifications

Working Conditions/Physical Demands

Standard office work

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