Physician Insurance Reviewer Jobs in Rochester, NY

60 Corporate Woods

Time as Reported / Per Diem

R269925

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

60 Corporate Woods, Brighton, New York, United States of America, 14623

Opening:

Worker Subtype:

Regular

Time Type:

Time as Reported / Per Diem

Scheduled Weekly Hours:

As Scheduled

Department:

500708 CVSL RCPG & Cardiac Rehab

Work Shift:

UR - Day (United States of America)

Range:

UR URCA 205 H

Compensation Range:

$20.30 - $27.41

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.

Responsibilities:

Performs complex secretarial and administrative duties in a fast-paced environment supporting clinical, educational, and academic programs. Responsible for all clinic preparations, including but not limited to providers' time and calendar management while optimizing provider-patient schedule, coordination of patient care, and information/data support.

ESSENTIAL FUNCTIONS

• Serves as primary contact for provider(s). Manages provider(s) calendar and prioritizes appointments and meetings based on provider preferences. Chooses and recommends among competing demands. Examines the clinical schedule(s) on a continuous basis to identify opportunities for optimizing the time and effort of providers. Finds missing orders and sends them for review and approval. Anticipates needs of insurance companies by gathering all necessary information for referrals and prior authorizations. Applies provider preferences and protocols in selecting multiple possibilities to execute and/or delegate follow-up actions based on the provider's patient notes. Composes, edits, and obtains signatures for non-routine letters of correspondence related to appeals on denied claims, including compiling all necessary information and drafts for provider signature. Manages provider(s) documentation and information. Composes and types non-routine correspondence providing factual information. Arranges travel, conference registration, and hotel accommodations. Interfaces with organizations, hospitals, and others to facilitate invited lectures and speaking engagements for the provider. Researches hospital medical records for the information requested by physicians, insurance companies, and attorneys.

• Determines the order of daily surgeries and ambulatory procedures based on the patient's medical conditions and severity. Negotiates surgical/procedure schedule by communicating complex details directly to the Operating Room scheduling office and Ambulatory Surgical Center Staff. Authorizes overbooking and rearranging of surgeon's Operating Room schedules based on case complexity and medical urgency. Authorizes rescheduling when cancellations occur by applying protocols for surgical scheduling. Orders all necessary surgical/procedure equipment, devices, and medication based on the application of protocols needed to conduct the surgery/procedure. Follows-up to confirm the order is fulfilled and ready for surgery/procedure. Employs multiple contingency strategies to ensure all details, materials, and locations are ready for surgery/procedures as scheduled. Ensures patient education and follow-up details vary according to pre-operative readiness and post-operative rehabilitation expectations and activities. Accountable for completeness of all relevant information from pre-op testing and evaluations for review by the anesthesiologist and the Operating Room.

• Assembles the necessary details from multiple tabs within the electronic medical record for review and inclusion when completing disability paperwork. Assesses calls to understand patient needs, prioritizes medical concerns, and obtains responses from providers and follows up with patients. Serves as main point of contact for patients pre and post-operative.

• Other duties as assigned.

MINIMUM EDUCATION & EXPERIENCE

• High School diploma and 2 years of relevant experience required

• Or equivalent combination of education and experience

• Medical Terminology, experiences with surgical/appointment scheduling software (such as Flowcast), and electronic medical records preferred

KNOWLEDGE, SKILLS AND ABILITIES

• Demonstrated customer relations skills required

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University's Mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.

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Learn. Discover. Heal. Create.

Located in western New York, Rochester is our namesake and our home. One of the world's leading research universities, Rochester has a long tradition of breaking boundaries-always pushing and questioning, learning and unlearning. We transform ideas into enterprises that create value and make the world ever better.

If you're looking for a career in higher education or health care, the University of Rochester may offer the perfect opportunity for your background and goals.

At the University of Rochester, we are committed to fostering, cultivating, and preserving an inclusive and welcoming culture and are united by a strong commitment to be ever better-Meliora. It is an ideal that informs our shared mission to ensure all members of our community feel safe, respected, included, and valued.