Title: Pre-Authorization Specialist-Surgery  

Location: Midtown  

Org Unit: Billing 

Work Days: Monday-Friday 

Weekly Hours: 35.00 

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

Responsible for the management of prior authorizations of all services requiring referrals in order to expedite the collection process and assure revenues from all charges utilizing the correct codes.

Job Responsibilities Assists with the development and implementation of strategies and procedures that will improve the integrity of the pre-authorization process for better identification of procedures to be performed. Attends workshops and seminars to keeps abreast of billing policies and procedures. Maintains up-to-date policies and procedures and knowledge related to federal and state healthcare laws, regulations and rules. Communicates with insurance providers about the patient’s medical necessity. Obtains, reconciles and updates retroactive authorization numbers, institutional and from insurance providers, for scheduled and pre-authorized procedures. Generates work lists of authorizations needed. Ensures patient demographic information matches services performed and authorization number. Corrects any errors within the practice management system to ensure accurate claims are sent to insurance carriers. Identifies patient with outstanding balances and informs provider who may seek total balance to be collected or financial arrangements to be made.  Performs other related duties as assigned. Education High School Diploma Experience

Approximately 2 years prior related experience within the medical field.

Demonstrated experience with insurance pre-certification procedures.

Demonstrated knowledge of third party insurance billing policies and procedures.

Knowledge, Skills and Abilities Demonstrated strong communication and interpersonal skills; demonstrated ability to interact with multiple constituencies and exercise "people skills". Demonstrated proficiency with MS Office Suite and database applications. Demonstrated organizational skills and ability to pay close attention to detail. Demonstrated critical thinking and analytical skills. Demonstrated ability to multi-task and prioritize in a fast-paced environment. Demonstrated ability to remain focused despite frequent interruptions. Ability to treat confidential information with utmost discretion. Demonstrates ability to exercise standards of professionalism, including appearance, presentation and demeanor. Demonstrated ability to work effectively in a collaborative manner with all departmental faculty and staff, as well as other institutional representatives. Licenses and Certifications Working Conditions/Physical Demands

Standard office work

 

 

 

 

 

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 protected status, including race, sex, sexual orientation, gender identity, national origin, color, age, religion, protected veteran or disability status, or genetic information.