Pre-Authorization Specialist

2 months ago


New York, United States Manhattan Specialty Care Full time
Manhattan Gastroenterology is looking for a Pre-Auth Specialist to join our billing team. We are looking for someone who is dependable, likes taking on challenges, and meets deadlines. This position is working out of our Chelsea office.

Responsibilities include:
  • responsible for the management of insurance verifications, eligibility and prior authorizations for services requiring referrals, including surgical procedures, visits and diagnostic testing
Ensures that patient demographic, insurance information, verification and eligibility have been established and documented

Verifies pre-certifications and obtains if needed

If pre-certification is not obtained for next day, notifies the referring doctor's office and contacts the patient to find out if they would rather reschedule

Verifies patient insurance eligibility and obtains necessary pre-authorization numbers, if required, prior to appointment date

Documents and communicates with clinical staff, physicians, administrators and patients regarding insurance problems/discrepancies; contacts patients to receive updated insurance information or correct issues

Scans documentation into the EMR system as necessary

Inputs and/or obtains authorizations/precertifications into and from within online systems

Initiates and prepares written correspondence as needed and based on functional needs

Disseminates information to colleagues and/or staff as appropriate

Qualifications
  • 2+ Years of Medical billing or healthcare admin Experience
  • Goal-oriented
  • Ability to interpret reports
  • Must be able to work collaboratively in a team environment
  • Can organize and multi-task work responsibilities while completing deadlines


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