Prior Authorization Associate Jobs in New York (NOW HIRING)

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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.

Opportunity to grow as part of the Practice Associate Career Ladder!

Job Summary:

The Practice Associate III is responsible for the patient welcome experience for the Department of Otolaryngology, including collecting demographic and insurance information, scheduling appointments and surgeries, and other duties necessary to provide efficient, timely services to the patients, their families, and providers. This position is an advanced role that supports peers with expertise, organizational knowledge and guidance in support of the day-to-day operations in the Department of Otolaryngology. The Practice Associate III is part of a team that delivers an exceptional patient experience that contributes to positive health outcomes for patients and a work culture of Service-Oriented, Trust, Empathy, Safety, Inclusion, and Communication.

Job Responsibilities:

• Greet patients and visitors & answer telephone calls.
• Conduct pre-registration, check-in, check-out, appointments, and other related tasks as requested.
• Obtain all required registration and intake information from patients; verify and/or update any new insurance or other information in Epic; obtain prior authorizations and referrals for visits and tests and verify eligibility for services; accurately indicate arrivals, no-shows, reschedules, and physician cancellations in Epic; collect all time-of-service and past due payments. Initiate registration of new patients in Epic as needed.
• Manage and review physician’s schedule to ensure all authorizations and pre-certifications for office visits and procedures are obtained.
• May collect all time-of-service and past due payments prior to the start of the appointment. Settle cash drawer in the EHR on a daily basis.
• Coordinate and schedule appointments, procedures, and other specialty services/clinical testing as requested by the physician in a timely and accurate manner. Prepare requisitions as needed.
• Organize surgical and/or procedure requests and schedule in Epic for audiology and/or high complexity cases. Obtain all required authorizations, coordinate/schedule diagnostic testing as ordered by physicians, obtain all necessary documentation and all related tasks to successfully complete pre-op/pre-procedure activities.
• Schedule post-operative and other follow-up appointments and other related tests as requested by the physician in a timely and accurate manner. Respond to financial information inquiries such as explanation of charges, out of network benefits, out of pocket expenses, and related activities. Obtain prior authorizations and referrals for follow-up care as needed by insurance plan.
• Ensure that patients have appropriate instructions related to the surgery or procedure, including pre-and post-operative directions.
• Assist with coordination of care to other specialties and appointments.
• Verify patient insurance eligibility and benefits as needed. Communicate insurance participation, financial responsibility (if applicable), and time of service policy to patient population.
• Respond to financial information inquiries such explanation of charges, out of network benefits, out of pocket expenses, and related activities.
• Conduct all pre-determination, authorization, and pre-certification. Manage these processes and documentation closely to ensure no scheduling delays.
• Review the daily and weekly schedule frequently to ensure accuracy of the visit provider, appointment duration, patient insurance participation status with the visit provider, visit reason, and visit type.
• Perform administrative duties as it pertains to practice or specialty. This may include providing administrative support to providers, managing physician academic and clinical calendars, managing medical record release authorizations, securing hearing aid benefits, assisting with billing formatting, participating in projects and/or meetings, and completing other tasks as assigned by management.
• Assist with onboarding and training of new staff and help colleagues address training gaps.
• Serve as a first point of escalation for complex cases or front desk issues.
• Serve as team point person or task monitor as directed by Supervisor.
• Manage all assigned Epic work queues. Assist others with backlog or increased volume activity.
• Follow end-of-day closing procedures.
• Provide general administrative support to physicians and managers.
• Maintain follow-up on projects/reports and inform physicians and managers of critical situations or changes.
• Provide cross coverage as directed by Supervisor/Manager.
• Perform other related duties as assigned.

Job Qualifications:

• High school diploma or equivalency is required.
• A minimum of 5 years’ relevant experience, including in a medical office environment.
• Advanced knowledge of/proficiency with medical terminology.
• Advanced proficiency with and/or understanding of medical billing and up-to-date insurance eligibility.
• Proficiency with or understanding of surgical and procedural scheduling.
• Strong service orientation, including interpersonal and communication skills, emotional intelligence, and ability to deliver consistent exceptional service while demonstrating tact, respect and sensitivity.
• Advanced organizational and problem-solving skills, including the ability to prioritize, multitask, and manage complex cases. Ability to work independently with consistent follow-through.
• Excellent relationship management skills including, but not limited to, emotional intelligence, interpersonal skills, empathy, and ability to handle situations with respect, tact, and sensitivity.
• Excellent team collaboration and mentorship skills including, but not limited to, emotional intelligence, interpersonal and communication skills, empathy, and ability to lead others through new and changing situations.
• Strong proficiency with Microsoft Office (Word and Excel) or similar software is required, and an ability and willingness to learn new systems and programs.
• Experience in Otolaryngology/Audiology preferred.
• Experience in Epic preferred.
• Bilingual English/Spanish a plus, but not required.

Hourly Rate Ranges: $28.13 - $35.16

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 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.