Specialist Precertification

nyp; United States; On-site; USD 36,000 - 48,000; Full time

Job summary

NewYork-Presbyterian Hospital is seeking a Prec ertification Specialist for the Central Billing Office in New York, NY. You will verify insurance, obtain precertifications, document in the EHR, and ensure payer compliance to support a smooth revenue cycle.

The role emphasizes accuracy, attention to detail, and strong communication with patients and providers while working on-site at NYP.

Qualifications

• High School diploma or GED required.
• Minimum of 1 year related experience.
• Proficiency in insurance verification, precertification and EHR.

Responsibilities

• Process pre-certification requests accurately and timely.
• Verify insurance coverage and obtain required authorizations.
• Document in the EHR and maintain payer compliance.
• Contribute to reducing claim denials and support revenue cycle.
• Communicate effectively with patients, providers, and payers.

Skills

Insurance verification

Precertification

EHR navigation

Interpersonal communication

Time management

Education

Bachelor degree

High School diploma or GED

Tools

Microsoft Office

EHR system

Job description

Location

New York, New York

Shift

Day (United States of America)

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.

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.