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SalaryTitle: Pre-Authorization Specialist
Title: Pre-Authorization Specialist
Location: Midtown
Org Unit: Billing
Work Days: Monday-Friday
Exemption Status: Non-Exempt
Salary Range: $32.97 - $39.73
- 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 benefits, and prior authorizations for services provided. Serves as liaison between junior pre-Authorization staff and department leadership.
Job Responsibilities
- Verifies pre-authorizations and obtains upgrades if needed. If pre-authorization is not obtained for next day, notifies referring provider’s office and contacts patient to provide option to reschedule or sign a financial waiver of liability.
- 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.
- If applicable, ensures that provider participation database is updated as new insurance plans/products are identified during the verification/authorization process.
- Assists financial clearance and billing matters as needed, including but not limited to denial management WQs, CPT adjustments, research AR, and compliance.
- Assists with creation and implementation of department workflows, standards, and policies. Disseminates information to colleagues and/or staff as appropriate, including organized trainings for senior staff and new hires.
- As needed, offers support to junior pre-authorization staff regarding patient inquiries, disputes, etc.,
- Performs other related duties as directed.
Education
- High School Diploma
Experience
At least two (2) years prior related experience within the medical field.
Knowledge, Skills and Abilities
- Demonstrated experience with insurance verifications, and pre-authorization procedures.
Licenses and Certifications
Working Conditions/Physical Demands
Weill Cornell Medicine is a comprehensive academic medical center that is committed to excellence in patient care, scientific discovery, and the education of future physicians and scientists in New York City and around the world. Our doctors and scientists - faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and the Weill Cornell Physician Organization - are engaged in world-class clinical care and cutting-edge research that connect patients to the latest treatment innovations and prevention strategies. Located in the heart of the Upper East Side's scientific corridor, Weill Cornell Medicine's powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U.S. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey. Our medical practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian/Lower Manhattan Hospital, NewYork-Presbyterian Hospital/Brooklyn Methodist Hospital, NewYork-Presbyterian Hospital/Westchester Behavioral Health Center, and NewYork-Presbyterian/Queens. At Weill Cornell Medicine, we work together to treat each individual, not just their conditions or illnesses, as we strive to deliver the finest possible care for our patients - the center of everything we do. Weill Cornell Medicine is an Equal Employment Opportunity Employer. Weill Cornell Medicine provides equal employment opportunities to all qualified applicants without regard to race, sex, sexual orientation, gender identity, national origin, color, age, religion, protected veteran or disability status, or genetic information.
Nearest Major Market: Manhattan
Nearest Secondary Market: New York City
