Pre-Authorization Coordinator


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Title: Pre-Authorization Coordinator Location: Lower East Side Org Unit: WCINYP Pre-Authorization Work Days: Exemption Status: Non-exempt

Position Summary

Under direction, is responsible for the management of insurance verifications, eligibility and prior authorizations for services requiring referrals, including surgical procedures, visits and diagnostic testing

Job Responsibilities

Ensures that patient demographic, insurance information, verification and eligibility have been established and documented.
Verifies pre-certifications and obtains upgrades if needed. If pre-certification is not obtained for next day, notifies the referring doctor’s office and contacts the patient to find out if they would rather reschedule.
Responsible for obtaining financial clearance and/or prior balances patients may have.
Verifies patient insurance eligibility and obtains necessary pre-authorization numbers, if required, prior to appointment date. Facilitates the communication and collection of any fees due from patient.
Documents and communicates with clinical staff, physicians, administrators and patients regarding insurance problems/discrepancies; contacts patients to receive updated insurance information or correct issues.
Scans documentation into the EMR system as necessary. Inputs and/or obtains authorizations/precertifications into and from within online systems.
Initiates and prepares written correspondence as needed and based on functional needs.
Attends workshops, seminars and/or conferences to keep abreast of standards and best practices within the field. Disseminates information to colleagues and/or staff as appropriate.
Performs other related duties as assigned.

Education

High School Diploma

Experience

Approximately 2 years prior related experience within the medical field

Knowledge, Skills and Abilities

Knowledge of CPT, ICD9, and ICD10 coding.
Excellent communication skills (both verbal and written).
Professional appearance, punctuality and a sense of urgency.
Ability to plan and prioritize work while responding to rapidly changing priorities.
Detail oriented.

Working Conditions/Physical Demands

Standard office work Role may require the ability to work flexible hours, which may include early mornings and/or late nights.
Weill Cornell Medicine is a comprehensive academic medical center that’s committed to excellence in patient care, scientific discovery, and the education of future physicians in New York City and around the world. Our doctors and scientists-faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and the Weill Cornell Physician Organization-are engaged in world-class clinical care and cutting-edge research that connect patients to the latest treatment innovations and prevention strategies. Located in the heart of the Upper East Side’s scientific corridor, Weill Cornell Medicine’s powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U.S. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey. Our medical practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian/Lower Manhattan Hospital, and NewYork-Presbyterian/Queens. At Weill Cornell Medicine, we work together to treat each individual, not just their conditions or illnesses, as we strive to deliver the finest possible care for our patients – the center of everything we do. Weill Cornell Medicine is an Equal Employment Opportunity Employer. Weill Cornell Medicine provides equal employment opportunities to all qualified applicants without regard to race, sex, sexual orientation, gender identity, national origin, color, age, religion, protected veteran or disability status, or genetic information.

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