- Review chart documentation to ensure patient meets medical policy guidelines
- Prioritize incoming authorization requests according to urgency
- Obtain authorization via payer website, fax or by phone and follow up regularly on pending submission
- Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
- Initiate appeals for denied or modified authorizations
- Respond to clinic questions regarding payer medical policy guidelines
- Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
- Other duties as assigned
- Knowledge of treatment authorization and its direct impact on the practice's revenue cycle
- Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
- Proficient use of CPT and ICD-10 codes
- Excellent computer skills including Adobe, Excel and Internet use
- Detail oriented with above average organizational skills
- Plans and prioritizes to meet deadlines
- Excellent customer service skills; communicates clearly and effectively
- Ability to efficiently manage and prioritize time-sensitive tasks that arise
- High School Diploma or GED
- 2 years medical prior authorization experience preferred
- 2 years experience with conservative specialties (Chiropractic, Physical Therapy or Occupational Therapy) preferred.
- Collaborative environment fostering continued growth in a multidisciplinary approach
- VERY competitive salary and a runway for professional growth
- Medical, Dental, and Vision Insurance
- Accrued paid time off, sick time, and six paid company holidays
- Annual CEU reimbursement budget for licensed clinicians
- Retirement savings account with a percentage based company match
- Hybrid
- Monday to Friday
-
Precertification Specialist
2 weeks ago
Alliance Health System Matawan, United StatesPrecertification Specialist · DESCRIPTION · The Precertification Specialist is responsible for obtaining prior authorizations for all treatment by successfully completing the authorization process with all commercial, automobile and workers compensation payers. · RESPONSIBILITIES ...
-
Precertification Specialist
1 week ago
NavitsPartners Jackson Heights, United StatesJob Description · Job DescriptionPosition: Precertification Specialist · Location: Flushing, NY · Duration: 2 Months · Shift:9:00 am - 5:00 pm (includes a 60-minute break) · Department:OBGYN · Job Summary:The Precertification Specialist is responsible for managing the precertifi ...
-
Precertification Specialist
2 weeks ago
Pride Health New York, United StatesJob Title: Precertification Specialist · Location: Flushing, NY 11355 · Shift: Days (M-F) · Duration: 2 Months with a strong possibility of extension · Pay Range: $24 to $26/Hour. · Job Description: · Knowledge of pre authorization OB/GYN ultrasound and CPT codes. · Minimum form ...
-
Precertification Specialist
1 week ago
Vezita Healthcare Inc / DBA - Vezita Consulting Corona, United StatesJob Description · Job DescriptionPosition: Precertification SpecialistFacility: NYP QueensLocation: Flushing, NY 11355 Rate: $ 27 /hr.Duration: 3 Months (Possible ext)Shift: 9:00 am - 5:00 pm (includes a 60 min break) ...
-
Billing/Precertification Specialist
2 weeks ago
Kwfc Radio New York, United States: · Gastroenterology Consultants of Augusta is looking for an experienced Billing/Precertification Specialist to join our billing team. Duties include insurance verification, prior authorization, accounts receivable and phone customer service. The position is full time, Monday th ...
-
Patient Access Specialist- Ft- Day
2 weeks ago
Hackensack Meridian Health Edison, United StatesOverview: · "Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, ...
-
Benefit Verification Specialist
1 week ago
Manhattan Endoscopy Center (MECN) New York, United States**Manhattan Endoscopy Center (MECN), a GI focused Ambulatory Surgery Center (ASC) located in New York, NY, has an exciting opportunity for a full-time Benefit Verification Specialist to join their team** · **What makes us awesome**: · - Perks and benefits offered to eligible empl ...
-
Patient Access Specialist
2 weeks ago
Hackensack Meridian Health Neptune City, United StatesOverview: · "Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, ...
-
Authorization-referrals Specialist Ii #full Time
3 weeks ago
61st Street Service Corp New York, United States Full time**Job Summary**: · The Authorization-Referrals Specialist II is responsible for verifying insurance policy benefit information, and securing payer required referrals and authorizations. This position is responsible for obtaining accurate and timely pre-authorizations for professi ...
-
Credit Interviewer
1 week ago
Brookdale Hospital Medical Center Brooklyn, United StatesThe role of the **Credit Interviewer** is to obtain insurance information and perform verification of all demographic information for each account. Interview patients as necessary to verify insurance and demographic information, and collects signatures on Medicare Secondary Payer ...
-
Medical Secretary #full Time
2 weeks ago
61st Street Service Corp New York, United States Full time**Job Summary**: · The Medical Secretary will be responsible for assisting with the day-to-day operations of a high-volume practice. · **Responsibilities**: · - Maintain, manage, and distribute physician schedules to the practice, clinic staff and administration · - Answer phones ...
-
Patient Access Specialist
2 weeks ago
Hackensack Meridian Health Neptune City, United StatesOverview: · "Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, ...
-
Medical Secretary langone Orthopedic Center
3 weeks ago
NYU Langone New York, United States**NYU Langone Health** is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's h ...
-
Medical Secretary
3 weeks ago
NYU Langone Health New York, United States**NYU Langone Health** is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's h ...
-
Medical Secretary
2 weeks ago
NYU Langone New York, United States**NYU Langone Health** is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's h ...
-
Medical Secretary
2 weeks ago
NYU Langone Health New York, United States**NYU Langone Health** is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's h ...
-
Medical Secretary
2 weeks ago
NYU Langone Health New York, United States**NYU Langone Health** is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's h ...
-
Medical Secretary
1 week ago
NYU Langone New York, United States**NYU Langone Health** is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's h ...
-
Business Office Float Prn
6 days ago
Surgical Specialists at Princeton (10909) Princeton, United States**_Surgical Specialists of Princeton_** has an immediate need for a PRN Business Office Float · **Job Summary**: Under the direction of the Business Office Manager, is responsible for covering any aspect of the business office necessary. Many duties includes scheduling, insurance ...
-
Business Office Float Full Time
6 days ago
United Surgical Partners International Inc (USPI) Princeton, United States Full time**_Surgical Specialists of Princeton_** has an immediate need for a full time Business Office Float · **Job Summary**: Under the direction of the Business Office Manager, is responsible for covering any aspect of the business office necessary. Many duties includes scheduling, ins ...
Precertification Specialist - Matawan, United States - Alliance Health System
Description
Job Description
Job DescriptionPrecertification Specialist
DESCRIPTION
The Precertification Specialist is responsible for obtaining prior authorizations for all treatment by successfully completing the authorization process with all commercial, automobile and workers compensation payers.
RESPONSIBILITIES
KNOWLEDGE, SKILLS, AND ABILITIES
EDUCATION/EXPERIENCE REQUIRED
Benefits:
Work Location:
Schedule:
COVID-19 considerations: Alliance Orthopedics is educating employees and patients about steps they can take to protect themselves and others through the implementation of the CDC recommendations. We are also implementing additional measures to keep our facilities clean.
