Pre-Authorization Specialist
New York, NY
Updated: June 17
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Title:
Pre-Authorization Specialist
Title: Pre-Authorization Specialist
Location: Midtown
Org Unit: Coding Administration
Work Days: Monday-Friday
Weekly Hours: 35.00
Exemption Status: Non-Exempt
Salary Range: $34.78 - $37.80
- As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices
Position Summary
Under direction, is responsible for the management of insurance verifications, eligibility and benefits, and prior authorizations for services provided. Serves as liaison between junior pre-Authorization staff and department leadership.
Job Responsibilities
- Verifies pre-authorizations and obtains upgrades if needed. If pre-authorization is not obtained for next day, notifies referring provider’s office and contacts patient to provide option to reschedule or sign a financial waiver of liability.
- Verifies patient insurance eligibility and obtains necessary pre-authorization numbers, if required, prior to appointment date. Facilitates the communication and collection of any fees due from patient.
- If applicable, ensures that provider participation database is updated as new insurance plans/products are identified during the verification/authorization process.
- Assists financial clearance and billing matters as needed, including but not limited to denial management WQs, CPT adjustments, research AR, and compliance.
- Assists with creation and implementation of department workflows, standards, and policies. Disseminates information to colleagues and/or staff as appropriate, including organized trainings for senior staff and new hires.
- As needed, offers support to junior pre-authorization staff regarding patient inquiries, disputes, etc.,
- Performs other related duties as directed.
Education
- High School Diploma
Experience
At least two (2) years prior related experience within the medical field.
Knowledge, Skills and Abilities
- Demonstrated experience with insurance verifications, and pre-authorization procedures.
Licenses and Certifications
Working Conditions/Physical Demands
Standard office work
Cornell welcomes students, faculty, and staff with diverse backgrounds from across the globe to pursue world-class education and career opportunities, to further the founding principle of “any person, any study.” No person shall be denied employment on the basis of any legally protected status or subjected to prohibited discrimination involving, but not limited to, such factors as race, ethnic or national origin, citizenship and immigration status, color, sex, pregnancy or pregnancy-related conditions, age, creed, religion, actual or perceived disability (including persons associated with such a person), arrest and/or conviction record, military or veteran status, sexual orientation, gender expression and/or identity, an individual’s genetic information, domestic violence victim status, familial status, marital status, or any other characteristic protected by applicable federal, state, or local law.
Cornell University embraces diversity in its workforce and seeks job candidates who will contribute to a climate that supports students, faculty, and staff of all identities and backgrounds. We hire based on merit, and encourage people from historically underrepresented and/or marginalized identities to apply. Consistent with federal law, Cornell engages in affirmative action in employment for qualified protected veterans as defined in the Vietnam Era Veterans’ Readjustment Assistance Act (VEVRRA) and qualified individuals with disabilities under Section 503 of the Rehabilitation Act. We also recognize a lawful preference in employment practices for Native Americans living on or near Indian reservations in accordance with applicable law.
Nearest Major Market: Manhattan
Nearest Secondary Market: New York City
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Verifies pre-authorizations and obtains upgrades if needed. If pre-authorization is not obtained for next day, notifies referring provider’s office and contacts patient to provide option to reschedule or sign a financial waiver of liability. Verifies patient insurance eligibility and obtains necessary pre-authorization numbers, if required, prior to appointment date. Facilitates the communication and collection of any fees due from patient. If applicable, ensures that provider participation database is updated as new insurance plans/products are identified during the verification/authorization process. Assists financial clearance and billing matters as needed, including but not limited to denial management W - Qs, CPT adjustments, research AR, and compliance. Assists with creation and implementation of department workflows, standards, and policies. Disseminates information to colleagues and/or staff as appropriate, including organized trainings for senior staff and new hires. As needed, offers support to junior pre-authorization staff regarding patient inquiries, disputes, etc., Performs other related duties as directed. Education High School Diploma Experience At least two (2) years prior related experience within the medical field. Knowledge, Skills and Abilities Demonstrated experience with insurance verifications, and pre-authorization procedures. Licenses and Certifications
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