Prior Authorization Specialist

Manhattan Gastroenterology is looking for a Prior Authorization Specialist to join our billing team. We are looking for someone who is dependable, likes taking on challenges, and meets deadlines. This position is working out of our Chelsea office.

Responsibilities include:

-Responsible for the management of insurance verifications, eligibility and prior authorizations for services requiring referrals, including surgical procedures, visits and diagnostic testing

-Ensures that patient demographic, insurance information, verification and eligibility have been established and documented
-Verifies pre-certifications and obtains if needed

-If pre-certification is not obtained for next day, notifies the referring doctor's office and contacts the patient to find out if they would rather reschedule
-Verifies patient insurance eligibility and obtains necessary pre-authorization numbers, if required, prior to appointment date
-Documents and communicates with clinical staff, physicians, administrators and patients regarding insurance problems/discrepancies; contacts patients to receive updated insurance information or correct issues
-Scans documentation into the EMR system as necessary
-Inputs and/or obtains authorizations/pre-certifications into and from within online systems
-Initiates and prepares written correspondence as needed and based on functional needs
-Disseminates information to colleagues and/or staff as appropriate