Authorization & Referrals Specialist II #Full Time

Top Healthcare Provider Network

The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors’ practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties.

Job Summary:

The Authorization-Referrals Specialist II is responsible to ensure that patients have been authorized for specialty services and office visits. May act as a liaison between the patient provider/referring provider, primary care provider, and other parties involved in the plan of care. Appropriately link referrals for identified visits.

Job Responsibilities:

• Ensure patients have been cleared for specialty services and office visits.
• Resolve authorization concerns prior to any patient's appointment.
• Confirm insurance coverage or lack thereof for patient.
• Obtain authorizations if needed from insurance coverage.
• Process preauthorization forms for requesting physician office or provider.
• Process patient referrals and link referrals for identified visits.
• Assist patient in gaining appropriate physician, hospital, and medical referrals.
• Perform administrative duties, including answering telephones and greeting patients.
• Perform related duties as assigned.

Job Requirements:

• High school graduate or GED certificate is required.
• A minimum of 1 years’ experience in a physician billing or third-party payer environment.
• Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.
• Candidate must demonstrate the ability to understand and navigate the payer adjudication process.
• Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
• Patient financial and practice management system experience in Epic and or other of electronic billing systems is preferred.
• Knowledge of medical terminology is preferred.
• Previous experience in an academic healthcare setting is preferred.

Hourly Rate Ranges: $24.76 - $33.17

Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.

61st Street Service Corporation

At 61^st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.

We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.