Specialist Precertification

NewYork-Presbyterian Hospital; New York (NY); On-site; USD 37,000 - 48,000; Full time

Job summary

NewYork-Presbyterian Hospital seeks a Precertification Specialist for the Central Billing Office in New York, NY. Day shift performs verification of coverage, secures authorizations, and updates the EHR to ensure compliant claims processing.

The role emphasizes accuracy in precertification, strong communication, and collaboration with care teams to support revenue cycle and patient satisfaction.

Qualifications

• High School diploma or GED required.
• One year of related experience.
• Knowledge of insurance verification and precertification; familiarity with EHR and medical terminology preferred.
• Excellent proofreading, organizational, data-entry and time-management skills with strong written and oral communication.
• Ability to foster teamwork; strong interpersonal skills.
• Proficiency in Microsoft Office programs (Outlook, Word, Excel).
• Analytical thinking, problem identification, and considering alternatives.
• Notify supervisor of authorization issues to de-escalate conflicts.
• Ability to work independently within established protocols; maintain honesty, reliability and confidentiality.

Responsibilities

• Process pre-certification requests and verify insurance coverage.
• Obtain necessary authorizations via internet, telephone or fax.
• Document in the EHR system and ensure payer requirements are met.
• Support a smooth revenue cycle by minimizing claim denials and boosting patient satisfaction.

Skills

Insurance verification

Precertification

Communication skills

Data entry

Time management

Analytical thinking

Teamwork

Independence

Medical terminology

Education

High School diploma or GED

Bachelor degree

Tools

Microsoft Office (Outlook, Word, Excel)

Job description

Precertification Specialist - Central Billing Office

NewYork-Presbyterian/Weill Cornell Medical Center, an 862-bed medical center affiliated with Weill Cornell Medicine, provides emergency, primary, and specialty care in virtually every field of medicine. Our staff is dedicated to providing the highest quality, most compassionate care and service to each and every one of our patients and their families in a warm and friendly environment.

Location

New York, New York

Shift

Day (United States of America)

Description

Responsible for ensuring the timely and accurate processing of pre-certification requests by verifying insurance coverage, obtaining necessary authorizations (via internet, telephone, and/or fax), using/documenting within the Electronic Health Record (EHR) system, and maintaining compliance with payer requirements. This role is essential in minimizing claim denials and supporting a smooth revenue cycle to enhance both patient satisfaction and organizational financial health.

Preferred Criteria

• Bachelor degree

Required Criteria

• High School diploma or GED
• One year of related experience
• Must know insurance verification, obtaining insurance precertification, human relationship skills, and the EHR (Electronic Health Record). Working knowledge or familiarity with medical terminology is preferred, and an understanding of various services and procedures performed by the organization
• Requires proofreading and organizational skills, computer data entry, knowledge of medical terminology, multi-tasking, and time management skills, as well as the EHR (Electronic Health Record). Excellent interpersonal, oral, and written communication skills.
• Must be able to foster teamwork to accomplish projects.
• Proficient in Microsoft Office Programs such as Outlook, Word, and Excel.
• Analytical skills, critical thinking, problem identification, and identifying alternative courses of action.
• Problem identification, identifying alternative courses of action, and resolving conflicts. Notify the supervisor of authorization problems to de-escalate issues.
• Needs to be able to work independently and follow the protocols and processes in place. If decisions are not covered by established protocols currently in place, you will need to notify the appropriate supervisor in regard to appropriate direction. Demonstrates honesty, reliability, and confidentiality.

Join a healthcare system where employee engagement is at an all-time high. Here we foster a culture of respect, belonging, and inclusion. Enjoy comprehensive and competitive benefits that support you and your family in every aspect of life. Start your life-changing journey today.

Please note that all roles require on-site presence (variable by role). Therefore, all employees should live within a commutable distance to NYP.

NYP will not reimburse for travel expenses.

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NewYork-Presbyterian Hospital is an equal opportunity employer.

Salary Range

$26.50-$35.00/Hourly

It all begins with you. Our amazing compensation packages start with competitive base pay and include recognition for your experience, education, and licensure. Then we add our amazing benefits, countless opportunities for personal and professional growth and a dynamic environment that embraces every person. Join our team and discover where amazing works.