• Health Insurance & Authorization Specialist I

    Highland Hospital (Rochester, NY)


    16795BR

    Title:

    Health Insurance & Authorization Specialist I

    Department/Cost Center:

    846 - Business Office/Cashiers

    Job Description:

    The Health Insurance and Authorization Specialist is responsible to assess and perform quality control function for all preadmission visits on surgical inpatient, short stay 23 (SS23), Endo and ambulatory procedures ensuring all pertinent information is on file and accurately documented. These activities include review diagnosis and history for correct insurance coverage, insurance eligibility and coverage verification using the three patient identifiers, confirming prior authorization is on file for correct level of care, inquires on prior auth denials and works with the Provider’s office to resolve, requests estimated cost and collects deposits for non-covered services, ensures appropriate medical justification is documented for out-of-network payers, refers our self-pay patients to Financial Case Management (FCM) for Medicaid assessment or Financial Assistance, reviews and validates MSP questions, monitors Medicare days for exhausted benefits, identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests

    Salary Range:

    $19.62 - $26.49 an hour

     

    _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._

    Auto req ID:

    16795BR

    Job Requirements:

    1. Education: High school Diploma or equivalent required. Associate degree preferred in related discipline (admitting/registration/patient billing/insurance); or equivalent experience

    2. Experience: Minimum of 3 years of related experience preferably in a hospital setting, medical office billing and or knowledge of third-party insurance regulations.

    3. Skills: Require high degree of professionalism and motivation with excellent communication and customer service skills, and medical terminology. Good interpersonal and telephone skills. Detail oriented. Computer, copier and FAX skills.

    Employment Status:

    Full-Time

    Hours/Week:

    40

    Posting Title:

    Health Insurance & Authorization Specialist I

    City:

    Rochester

    Work Shift:

    Days

    Area of Interest:

    Clerical

     

    The Hospital is committed to equal opportunity for all persons regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law.