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We have an exciting opportunity to join our team as a FGP Rad Pre-Auth Assoc.
In this role, the successful candidate Under the general direction of the FGP Radiology Insurance Verification/Pre-cert Manager, the position is responsible for obtaining and documenting insurance verification and pre-authorizations and pre-certifications prior to patient appointments and facilitating patient administrative needs. They communicate directly with patients and referring physicians to obtain appropriate insurance and clinical information required to obtain an authorization from the appropriate utilization management company. They are required to contact patients directly and reschedule the exam if the authorization is not obtained prior to appointment time.
Maintains cooperative and professional relationships with physicians, nurses and office staff. Has a positive relationship with colleagues. Cooperates with supervisor and other members of the team. Works well with others. All other related duties as required.
Reschedules all patients for whom insurance verification/authorization information has not been obtained prior to the patient's appointment. Effectively obtains all necessary pre-registration information (i.e. demographic and insurance information) from patients, caregivers and other staff members. Answers phones and screens incoming calls. Accurately takes messages, provides information and/or redirects callers to the appropriate department in a timely manner. Sends timely requests to referring physicians for authorization when NYULMC Radiology cannot obtain. Communicates authorization cases denied for medical necessity or requiring peer-to-peer review to the referring physician for resolution. Documents authorization in EPIC according to defined protocol. Properly refers patients to the Financial Counselor as needed. Answers incoming calls from patients and referring physician offices regarding authorization status and pending requirements.
Maintains patient schedule and related insurance verification/pre-authorization information. Utilizes applicable computer systems to obtain insurance verification/pre-authorization for scheduled patients. Effectively communicates scheduled services and provides information to patients, caregivers, and other staff members as necessary.
To qualify you must have a High School Diploma and 2 years' relevant experience or the equivalent combination of education and experience. Must include prior medical scheduling experience and knowledge of insurance companies' admission procedures and policies to complete insurance verification and pre-authorization requirements and knowledge of medical terminology for multiple subspecialties. Proficiency with intermediate to advanced scheduling software, word processing, spreadsheet, database applications and Internet-based healthcare applications/websites. Moderate, accurate keyboarding skills. Highly detail-oriented with strong organizational, communication and customer services skills. Ability to multitask and prioritize in a fast-paced environment.
Bachelor's Degree and three years practice support and scheduling experience in a high-volume healthcare environment.
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU School of Medicine provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU School of Medicine is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online. If you wish to view NYU School of Medicine's EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.
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Internal Number: 68898137
About NYU Langone Medical Center
NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. Included in the 200+ locations throughout the New York area are five inpatient locations: Tisch Hospital, its flagship acute-care facility; Rusk Rehabilitation, ranked as one of the top 10 rehabilitation programs in the country; NYU Langone Orthopedic Hospital, a dedicated inpatient orthopedic hospital with all musculoskeletal specialties ranked top 10 in the country; Hassenfeld Children's Hospital at NYU Langone, a comprehensive pediatric hospital supporting a full array of children's health services; and NYU Langone Hospital—Brooklyn, a full-service teaching hospital and level 1 trauma center located in Sunset Park, Brooklyn. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute–designated cancer center, and NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history.