Authorization Specialist II #Full Time #Remote

Other Jobs To Apply

Top Healthcare Provider NetworkThe 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.This position is primarily remote, candidates must reside in the Tri-State area.Note: There may be occasional requirements to visit the office for training, meetings, and other business needs.Opportunity to grow as part of a Revenue Cycle Career Ladder!Job Summary:The Authorization Specialist II is responsible for verifying insurance policy benefit information, and securing payer required authorizations. This position is responsible for obtaining accurate and timely pre-authorizations for professional services prior to the patient's visit, scheduled admission, or immediately following hospital admission. Prior authorizations may include, but are not limited to surgical procedures, outpatient treatments, medications and diagnostic testing (i.e. ultrasounds, labs, radiology, IV therapy, referrals)Job Responsibilities: Verifies insurance coverage via system tools, payer portals (Electronic Query (Real-Time-Eligibility [RTE]/Insurance Payer Portal/Phone). Upon verification of patient's insurance coverage, update changes in the billing system. Confirms provider's participation status with patient's insurance plan/network. Determines payer referral and authorization requirements for professional services. Contacts patient and PCP to secure payer required referral for planned services. Documents referral in practice management system. Researches system notes to obtain missing or corrected insurance or demographic information. Reviews clinical documentation to insure criteria for procedure meets insurance requirements. Initiates authorization and submits clinical documentation as requested by insurance companies. Follows through on pre-certifications until final approval is obtained. Manage faxes, emails, and phone calls in a timely manner. Responds to voicemails and emails within same business day of receipt. Communicates with surgical coordinators regarding authorizations status or denials. Submits appeals in the event of denial of prior authorizations or denial of payment following procedures. Set up peer to peer calls with clinical providers and insurance companies, as needed. Calculate and document patient out of pocket estimates and provide to patient. Assists Supervisor with special projects and/or tasks. Assists Authorization-Referrals Specialist I with complex cases or questions. Serves as back-up to Authorization-Referrals Specialist III. Performs other job duties as assigned.Job Qualifications: Verifies insurance coverage via system tools, payer portals (Electronic Query (Real-Time-Eligibility [RTE]/Insurance Payer Portal/Phone). Upon verification of patient's insurance coverage, update changes in the billing system. Confirms provider's participation status with patient's insurance plan/network. Determines payer authorization requirements for professional services. Researches system notes to obtain missing or corrected insurance or demographic information. Reviews clinical documentation to insure criteria for procedure meets insurance requirements. Initiates authorization and submits clinical documentation as requested by insurance companies. Follows through on pre-certifications until final approval is obtained. Manage faxes, emails, and phone calls. Responds to voicemails and emails. Communicates with surgical coordinators regarding authorizations status or denials. Submits appeals in the event of denial of prior authorizations or denial of payment following procedures. Set up peer to peer calls with clinical providers and insurance companies, as needed. Calculate and document patient out of pocket estimates and provide to patient. Assists Supervisor with special projects and/or tasks. Assists Authorization Specialist I with complex cases or questions. Serves as back-up to Authorization Specialist III. Performs other job duties as assigned.Please note: While this position is primarily remote, candidates must be in a Columbia University approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the employee's responsibility and not be reimbursed by the company.Job Qualifications: High school graduate or GED certificate is required. A minimum of 1-year experience in a physician's billing or third payer environment. Candidate must demonstrate the ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations. Candidate must demonstrate strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner. Must demonstrate effective communication skills both verbally and written. Ability to multi-task, prioritize, document, and manage time effectively. Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.) Functional proficiency and comprehension of medical terminology. Experience in Epic and or other electronic billing systems is preferred. Knowledge of medical terminology, diagnosis and procedure coding is preferred. Previous experience in an academic healthcare setting is preferred.Hourly Rate Ranges: $23.69 - $32.00Note: 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 CorporationAt 61st 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.

Back to blog

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

Data Entry Question and Answer

$150 $49

Remote Question and Answer

$150 $49

Virtual Assistant Question and Answer

$150 $49

Content Moderator Question and Answer

$150 $49

Customer Service Question and Answer

$150 $49

Video Game Tester Question and Answer

$150 $49

Related Posts