Referral & Authorization Specialist - Care Lane Hematology/Oncology Clinic
Glens Falls Hospital · NY, US
4 days agoImpress employers and recruiters.
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About the Role
Join our team of insurance experts at Glens Falls Hospital! As a Referral & Authorization Specialist, you will be the vital link between oncology patients, providers, and insurance payers. Your expertise directly reduces patient stress and ensures seamless access to life-saving cancer treatments. This role is a prime launching pad to elevate your skills in medical billing, compliance, and Health Information Management (HIM).
Responsibilities
- Verify patient insurance eligibility, check medical necessity guidelines, and obtain prior authorizations from payers.
- Counsel patients on their insurance benefits, navigate financial obligations, and resolve coverage questions.
- Act as the central point of contact for Glens Falls Hospital clinic staff regarding authorizations, stay updated on new procedure guidelines, and assist with monitoring patient waiting workflows when needed.
- Act as the primary resource for clinical staff regarding authorization rules, and notify providers of any insurance obstacles.
- Track ongoing referrals and lead the follow-up process for insurance denials to secure proper reimbursement.
- Compile necessary medical records, clinical notes, and coding info (CPT/ICD) to submit accurate documentation.
Requirements
- High school diploma or GED equivalent.
- 4 years of healthcare insurance experience preferred (can substitute for an Associate degree).
- Familiarity with medical terminology, CPT/ICD coding, and Medicare/third-party regulations is highly desired.
- Fast and accurate typing skills (60 WPM preferred) and excellent computer proficiency.
- Exceptional customer service, multitasking abilities, and strong verbal/written communication skills.
Skills
- Medical terminology
- CPT/ICD coding
- Medicare/third-party regulations
- Typing (60 WPM)
- Computer proficiency
- Customer service
- Multitasking
- Verbal communication
- Written communication
Location
- Glens Falls
Work Type
- Full-time
- Part-time
Experience Level
- 4 years of healthcare insurance experience preferred
Education Level
- High school diploma or GED equivalent
- Associate degree (AAS) in Health Administration, Business, Finance, or a related field
Salary/Compensations
- $18.50 to $27.76 per hour
Benefits
- Competitive benefits offerings available to active, full-time and part-time employees who work at least 30 hours per week.
About the Company
- Our mission is to improve the health of people in our region by providing access to exceptional, affordable, and patient-centered care every day and in every setting.
- Located in the foothills of the beautiful Adirondack mountains, Glens Falls is conveniently located a short drive away from the capital region and Lake George.
- Work at the top of your profession and jumpstart your next career here at Glens Falls Hospital!
Equal Opportunity
- All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law.