Share Email Opening Title Authorization/Eligibility Specialist - NSC  EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.   Description JOB SUMMARY: The Authorization/Eligibility specialist works as a liaison between the Centralized Business Office, the physicians, and the patient. The position interfaces with physicians, patients, and administrative personnel and answers phone calls, responds to fax and email communication and routes messages accordingly. The focus of the position is to obtain prior authorizations for medications and/or procedures. To review patient insurance eligibility and process authorizations to ensure approvals are on file for each patient scheduled to receive services at the Practice. Duties include reviewing insurance information, requesting authorization from insurance carriers, and data entry.   JOB RESPONSIBILITES: Generates report from the Practice Management (PM) system to review the patients and services scheduled for the next business day Reviews patient insurance information to verify eligibility for scheduled services such as appointments, testing, and surgery Prints and/or saves eligibility forms for the front desk receptionists at assigned location the day before the appointment date Prepares and requests authorization for scheduled appointments and surgeries prior to the appointment/surgery date Processes any referral authorizations and sends referral requests to referring physician's offices, if needed Reviews all authorizations processed by the Front Desk Receptionists to ensure accuracy and completeness – fixes issues, if any Inputs patient demographics and insurance information into the PM system Troubleshoots any issues with patient eligibility and authorizations by contacting the insurance companies Receives any complex eligibility/authorization issues or questions and processes them accordingly Cancels or reschedules patients based on insurance information, as needed Provides coverage for front desk personnel, as needed Performs various administrative duties such as answering phones, directing calls or messages, accurately entering data into the patient medical records, and transporting files/materials between offices Works overtime as necessary Follows applicable policies and procedures and takes precautions to establish a safe work environment Maintains strict patient protocols in accordance with practice policies/ HIPAA requirements Maintains a high level of professionalism with patients and works to establish a positive rapport Performs other duties as assigned   Category Business Support   Exempt/Non-Exempt Non-Exempt   Location Cardiology- NSC East Setauket   Full-Time/Part-Time Full-Time   Position Requirements REQUIRED QUALIFICATIONS: Education: High School Diploma or equivalent required Experience: 1-3 years of related medical receptionist and/or related medical insurance/authorization experience required Knowledge of insurance carriers and vision plans such as HMO/IPA, Medicare, Medi-Medi, and VSP required Comfortable using a computer Language: Ability to read, write, and communicate in English; Bilingual in Spanish, a plus License/Certification: None   PREFERRED QUALIFICATIONS: EMR experience. Experience with managed care companies. Familiarity with medical terminology, CPT procedure codes, and ICD-10 codes.   PHYSICAL DEMANDS: Must be able to sit for long periods of time, and must have manual dexterity to work computer systems and keyboard. It is reasonable to anticipate lifting 10 -15 pounds in any given day.   In accordance with the New York State Department of Health (DOH) order that all hospitals and nursing homes “continuously require all covered personnel to be fully vaccinated against COVID-19.”  Upon receipt of a conditional job offer, candidates who are not already vaccinated must obtain the first dose of the vaccine within three (3) calendar days of job offer and must obtain any subsequent doses in accordance with the vaccine protocol. The order allows for limited medical exemptions with reasonable accommodations, consistent with applicable law.     Shift Days   Tags   Salary Range Commensurate with experience   Position Authorization/Eligibility Specialist   Open Date 6/14/2022   This position is currently not accepting applications. To search for an open position, please go to http://SBADMINISTRATIVESERVICESLLC.appone.com WE ALSO RECOMMEND Other Jobs Within Same Category Practice Transformation Specialist- CIN in Southampton, NY Posted on: 4/17/2024 [Apply Now] Medical Records Clerk in East Setauket, NY Posted on: 4/3/2024 [Apply Now] Authorization/Referral Specialist in Commack, NY Posted on: 3/26/2024 [Apply Now] Medical Proofreader in Stony Brook, NY Posted on: 2/7/2024 [Apply Now] Other Jobs Within 60 Miles Certified Nurse Midwife in Center Moriches, NY Posted on: 3/7/2024 [Apply Now] Registered Nurse-Fertility in Commack, NY Posted on: 3/21/2024 [Apply Now] Clinical Operations Manager-Cardiology in East Setauket, NY Posted on: 3/21/2024 [Apply Now] CRNA in Greenport, NY Posted on: 3/7/2024 [Apply Now] LPN in Mattituck , New York Posted on: 3/7/2024 [Apply Now] Follow us

 

AppOne.comTM   ©1999-2021 HR Services, Inc. Click here for technical assistance.