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 Referrals & Authorization Specialist III is responsible for verifying health insurance benefits for all new patients or existing patients. This position will contact the patient's insurance company to verify coverage levels and works with patients to walk them through their benefits information. The position works to ensure that patients have been authorized for specialty services and office visits. May act as a liaison between the patient, provider/referring provider and other parties involved in the plan of care. Appropriately link referrals for identified visits.

Job Requirements:

• Responsible for verifying patient insurance coverage, to ensure necessary non-invasive and invasive cardiac imaging procedures are covered and cleared by an individual's provider.
• Apply clinical data/knowledge to assist patients in gaining appropriate physician, hospital and medical referrals.
• Responsible for entering data in an accurate manner in order to update patient benefit information correctly in EMR and verify that existing information is accurate.
• 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.
• Maintain telephone service standards in accordance with the departmental/organizational policies.
• Assist patient in gaining appropriate physician, hospital, and medical referrals.
• Perform administrative duties, including answering telephones and greeting patients.
• Perform related duties as assigned.
• Assist with more complex patient issues and concerns.
• Assist supervisor/manager with monitoring inbound phone calls, call queue wait times and other assigned functions.
• Assists with training support of new hires.

Job Requirements:

• High school graduate or GED certificate is required.
• A minimum of 2 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.
• 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: $29.32 - $41.47

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.