Pre-Authorization Specialist — Insurance & Billing Liaison

Excelsior-Orthopaedics; Eggertsville (NY); On-site; USD 43,000 - 55,000; Full time

Job summary

Excelsior Orthopaedics in New York seeks a detail-oriented Pre-Authorization Coordinator to obtain and document pre-authorizations per payer requirements for services rendered. You will verify physician orders, explain co-pays and responsibilities to patients, and liaise with providers and billing teams to ensure accurate processing.

Strong knowledge of CPT/HCPCS/ ICD-10 codes and EMR experience (MEDENT preferred) are highly valued.

Qualifications

• High school diploma or equivalent.
• Knowledge of CPT, HCPCS, and ICD-10 codes preferred.
• EMR experience required; MEDENT preferred.
• Ability to prioritize tasks and work with interruptions.

Responsibilities

• Obtains pre-authorizations/pre-certification per payer requirements for services rendered and documents authorization information in the system.
• Verifies physician orders are accurate.
• Communicates insurance co-pays, deductibles, co-insurances, and out-of-pocket expenses to patients at point of service.
• Maintains communication with providers, clinical staff, and patients regarding authorization status.
• Assists billing in researching and resolving rejected or denied claims.
• Keeps management informed of changes in authorization processes and policy updates.

Skills

Pre-authorization

Insurance verification

Medical terminology

EMR

Billing research

Patient communication

Education

High school diploma

Tools

MEDENT

Job description

Excelsior Orthopaedics in New York seeks a detail-oriented Pre-Authorization Coordinator to obtain and document pre-authorizations per payer requirements for services rendered. You will verify physician orders, explain co-pays and responsibilities to patients, and liaise with providers and billing teams to ensure accurate processing.

Strong knowledge of CPT/HCPCS/ ICD-10 codes and EMR experience (MEDENT preferred) are highly valued.