Authorization Specialist

Location: Village of Nyack

## Authorization Specialist Apply:
2 Crosfield Avenue, Suite 202 (Neuro):
Full time:
Posted 3 Days Ago:
JR234245
** City/State:
** West Nyack, New York
** Department:
** Highland CBO
*
* Work Shift:

** Day
* * Work Days:
** MON-FRI
** Scheduled

Hours:

** 8:30 AM-5 PM
** Scheduled Daily

Hours:

** 8.5 HOURS
** Scheduled Weekly

Hours:

** 40
* * Hourly Rate/Range:
** 24.00

For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.

A.

*
* Job Summary:

** Acts as a liaison between healthcare providers, insurance carriers and patients to verify coverage eligibility, obtain pre-certification for treatments and radiologic imaging studies.

Schedule, reschedule, or cancel imaging exams. Clearly communicates procedure instructions, exam preparation requirements, and location directions to patients. Monitors the status of pending authorizations, communicate with payer case managers to expedite approvals and ensure required timelines are met.  Initiates and coordinates peer-to-peer reviews or appeals for authorization denials.  Accurately updates EPIC with authorization numbers, visit limits and expiration dates.  Educates patients and providers on coverage limitations or out of pocket costs.

Works well as part of a team supporting the maintenance of a well-organized and friendly work environment.  Assists office front end staff with urgent eligibility and pre-authorization functions as necessary.  Communicates with Practice Managers when necessary to help in facilitating authorizations timely.  
*
* B.
Essential Job Qualifications
**** 1.

Education:

** High School Diploma or equivalent required.
** 2.

Experience:

** One years’ experience preferred in a healthcare environment or a medical office or hospital setting. A general understanding of medical office procedures, billing, insurance carriers including Medicare and Medicaid preferred.  Must have experience working with computers; an electronic health record system; EPIC preferred.
** 3.
Training/Certification:
** N/A
** 4.
Licensure:
** N/A
** 5.
Other:
** High attention to detail, persistence in dealing with insurance call centers, and strong problem solving and communication skills. Proficiency and working knowledge of EPIC and Microsoft Office.  Must be thorough when documenting information in an electronic health record.
*
* B.
Job Specific Contacts
**** 1.
General Contacts:
** Patients and family members, physicians, physician extender(s), insurance representatives and employees.
*
* C.
Environment and Demands
**** Environmental Demands:
** The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. While performing the duties of this job, the employee is occasionally exposed to fumes or airborne particles, radiation, and exposure to infectious diseases. The noise level in this environment is usually moderate.
** Essential Physical and Cognitive Demands, Manual Dexterity:
** The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation will be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job the employee is occasionally required to stand; sit; walk; use hands to finger, handle, or feel objects, tools, or control;

reach with hands and arms; and stoop, kneel, crouch, or crawl. The employee must occasionally lift and move up to 50 pounds. Specific vision abilities required by this job include close vision. Some irregularity in scheduled hours because of compensated overtime…