Health Insurance & Authorization Specialist II

18272BR

Title:

Health Insurance & Authorization Specialist II

Department/Cost Center:

846 - Business Office/Cashiers

Job Description:

he Health Insurance and Authorization Specialist is responsible for verifying patient insurance eligibility and coverage and securing third-party payer authorization for our urgent/emergent inpatients, observation cases, maternity, and newborn admissions and notifies Utilization Management of clinical requests during the hospital stay. The Specialist also works closely with the uninsured/underinsured for appropriate referrals to our Financial Case Management team to assess patients for health insurance or financial assistance. They track our Medicare patients for benefit exhaustion to ensure compliance with Medicare Life Time Reserve (LTR) consent forms and consistently exercise judgment to resolve insurance barriers on the assigned admissions to avoid billing delays. This role involves a more significant amount of external coordination with outside agencies, including MVA/WC carriers, Motor Vehicle Accident Indemnification Corporation (MVAIC) agency, attorney offices, and works with parents to add their newborn through the NYS Marketplace or employer group.

Supervision: Responsible for monitoring own performance on assigned tasks. Self-directed and must make complex decisions independently. May train other support staff.

This role may have the option to work a hybrid-remote schedule and communicate daily through virtual meetings.

Salary Range:

$20.99- $28.34 an hour

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.

Auto req ID:

18272BR

Job Requirements:

1. Education: High school Diploma or equivalent required. Associate degree preferred in related discipline (admitting/registration/patient billing/insurance); or equivalent experience

2. Experience: Minimum of 3 years of related experience preferably in a hospital setting, medical office billing and or knowledge of third-party insurance regulations.

3. Skills: Require high degree of professionalism and motivation with excellent communication and customer service skills, and medical terminology. Good interpersonal and telephone skills. Detail oriented. Computer, copier and FAX skills.

Employment Status:

Full-Time

Hours/Week:

40hrs

Posting Title:

Health Insurance & Authorization Specialist II

City:

Rochester

Work Shift:

Days

Area of Interest:

Clerical

The Hospital is committed to equal opportunity for all persons regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law.