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About the Role

Under direction, this role is responsible for managing insurance verifications, eligibility and benefits, and prior authorizations for services provided. The specialist also serves as a liaison between junior pre-Authorization staff and department leadership.

Responsibilities

• Verifies pre-authorizations and obtains upgrades if needed.
• Notifies referring provider’s office and contacts patient if pre-authorization is not obtained for the next day, providing options to reschedule or sign a financial waiver of liability.
• Verifies patient insurance eligibility and obtains necessary pre-authorization numbers prior to appointment date.
• Facilitates the communication and collection of any fees due from patient.
• Ensures provider participation database is updated with new insurance plans/products.
• Assists with financial clearance and billing matters, including denial management, CPT adjustments, AR research, and compliance.
• Assists with the creation and implementation of department workflows, standards, and policies.
• Disseminates information to colleagues and staff, including trainings for senior staff and new hires.
• Offers support to junior pre-authorization staff regarding patient inquiries and disputes.
• Performs other related duties as directed.

Requirements

• At least two (2) years of prior related experience within the medical field.
• Demonstrated experience with insurance verifications and pre-authorization procedures.

Location

• Upper East Side

Work Type

• Onsite

Experience Level

• 2+ years

Education Level

• High School Diploma

Salary/Compensations

• $34.78 - $37.80

About the Company

• Cornell welcomes students, faculty, and staff with diverse backgrounds from across the globe to pursue world-class education and career opportunities, to further the founding principle of “any person, any study.”

Equal Opportunity

• No person shall be denied employment on the basis of any legally protected status or subjected to prohibited discrimination involving, but not limited to, such factors as race, ethnic or national origin, citizenship and immigration status, color, sex, pregnancy or pregnancy-related conditions, age, creed, religion, actual or perceived disability (including persons associated with such a person), arrest and/or conviction record, military or veteran status, sexual orientation, gender expression and/or identity, an individual’s genetic information, domestic violence victim status, familial status, marital status, or any other characteristic protected by applicable federal, state, or local law.
• Cornell University embraces diversity in its workforce and seeks job candidates who will contribute to a climate that supports students, faculty, and staff of all identities and backgrounds.
• We hire based on merit, and encourage people from historically underrepresented and/or marginalized identities to apply.
• Consistent with federal law, Cornell engages in affirmative action in employment for qualified protected veterans as defined in the Vietnam Era Veterans’ Readjustment Assistance Act (VEVRRA) and qualified individuals with disabilities under Section 503 of the Rehabilitation Act.
• We also recognize a lawful preference in employment practices for Native Americans living on or near Indian reservations in accordance with applicable law.