Authorization & Referrals Specialist III

Job not on LinkedIn

🔥 16 hours ago

🦌 Connecticut, New Jersey, +1 more states – Remote

🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote

💵 $28 - $36 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 3%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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61st Street Service Corp

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1981

🏥 Healthcare

⚕️ Healthcare Insurance

👥 HR Tech

Healthcare • Healthcare Insurance • HR Tech

61st Street Service Corp. is dedicated to transforming patient care by providing service-oriented human resources and payroll management. With a focus on healthcare excellence, the company offers continuous learning and career growth opportunities within a diverse and collaborative environment. Since 1982, they have been committed to improving healthcare services by supporting the workforce that serves patients.

📋 Description

• Verify insurance coverage via system tools and payer portals • Confirm provider participation status with patients’ insurance plans/networks • Determine payer referral and authorization requirements for professional services • Contact patients and PCPs to secure required referrals • Document referrals in the practice management system • Initiate authorizations and submit clinical documentation requested by insurance companies • Manage faxes, emails, and phone calls in a timely manner • Communicate authorization status or denials to surgical coordinators • Submit appeals for denied prior authorizations or payments • Calculate and document patient out-of-pocket estimates and provide them to patients • Assist supervisors with special projects and tasks • Assist Specialists I and II with complex referral, authorization, and eligibility cases • Assist with daily work assignment distribution • Assist with new-hire and refresher training materials • Monitor and replenish office supplies • Perform other assigned duties

🎯 Requirements

• High school graduate or GED certificate is required • A minimum of 2 years’ experience in a physician’s billing or third payer environment • Ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations • Certified Professional Coder certificate (CPC) is preferred • Experience in Epic and/or other electronic billing systems is preferred • Knowledge of medical terminology, diagnosis and procedure coding is preferred • Previous experience in an academic healthcare setting is preferred • Must reside in the Tri-State area: New York, New Jersey, or Connecticut

🏖️ Benefits

• Healthcare • Various other benefits • Paid Time Off • Competitive comprehensive benefit package