Pre-Authorization Coordinator

 Posted 2 days ago
     
 $27.47 - $32.64 per hour
  
2-5 years experience
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AI Summary

Responsible for managing insurance verifications, eligibility, and prior authorizations for surgical procedures and diagnostic testing. This includes coordinating with clinical staff and patients to resolve insurance discrepancies and documenting data in the EMR system.

Title: Pre-Authorization Coordinator  

Location: Upper East Side  

Org Unit: Billing 

Work Days: Monday-Friday 

Weekly Hours: 35.00 

Exemption Status: Non-Exempt

Salary Range: $27.47 - $32.64  

*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 services requiring referrals, including surgical procedures, visits and diagnostic testing

Job Responsibilities

  • Ensures that patient demographic, insurance information, verification and eligibility have been established and documented.
  • 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.
  • Responsible for obtaining financial clearance and/or prior balances patients may have.
  • 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.
  • Documents and communicates with clinical staff, physicians, administrators and patients regarding insurance problems/discrepancies; contacts patients to receive updated insurance information or correct issues. 
  • Scans documentation into the EMR system as necessary. Inputs and/or obtains authorizations/precertifications into and from within online systems.
  • Initiates and prepares written correspondence as needed and based on functional needs.
  • Attends workshops, seminars and/or conferences to keep abreast of standards and best practices within the field. Disseminates information to colleagues and/or staff as appropriate.
  • Performs other related duties as assigned.

Education

  • High School Diploma or equivalent required.

Experience

Approximately 2 years prior related experience in a customer service focused role.

Knowledge, Skills and Abilities

  • Knowledge of CPT, ICD9, and ICD10 coding.
  • Excellent communication skills (both verbal and written).
  • Professional appearance, punctuality and a sense of urgency.
  • Ability to plan and prioritize work while responding to rapidly changing priorities.
  • Detail oriented.

Licenses and Certifications

    Working Conditions/Physical Demands

    Role may be remote EST daytime shift. Dedicated workspace conducive to a healthy work environment.

    Role may require the ability to work flexible hours, which may include early mornings and/or late nights. 

     

    Cornell welcomes students, faculty, and staff with diverse backgrounds from across the globe to pursue world-class education and career opportunities, to further the founding principle of “any person, any study.” No person shall be denied employment on the basis of any legally protected status or subjected to prohibited discrimination involving, but not limited to, such factors as race, ethnic or national origin, citizenship and immigration status, color, sex, pregnancy or pregnancy-related conditions, age, creed, religion, actual or perceived disability (including persons associated with such a person), arrest and/or conviction record, military or veteran status, sexual orientation, gender expression and/or identity, an individual’s genetic information, domestic violence victim status, familial status, marital status, or any other characteristic protected by applicable federal, state, or local law. 

    Cornell University embraces diversity in its workforce and seeks job candidates who will contribute to a climate that supports students, faculty, and staff of all identities and backgrounds. We hire based on merit, and encourage people from historically underrepresented and/or marginalized identities to apply. Consistent with federal law, Cornell engages in affirmative action in employment for qualified protected veterans as defined in the Vietnam Era Veterans’ Readjustment Assistance Act (VEVRRA) and qualified individuals with disabilities under Section 503 of the Rehabilitation Act. We also recognize a lawful preference in employment practices for Native Americans living on or near Indian reservations in accordance with applicable law.

     

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