Job Summary: Reporting to the Business Manager, the Outpatient Administrative Specialist is responsible for obtaining insurance referrals and authorizations for outpatient office visits, diagnostic tests and lab work; working with patients, families, providers, ancillary departments and insurance carriers to ensure all encounters are appropriate for maximum reimbursement, minimal denials and adherence to carrier rules. Completes check in and scheduling for Clinician in Epic. Communicates authorization, benefits and limitations to providers and patients; obtaining ABN or Waiver of Liability signatures; working with providers to clarify patient documentation and coding requirements; obtaining and providing letters of medical necessity as needed, and coordinating new patient referrals for services. The Outpatient Administrative Specialist will work with various computer programs (EPIC, Chartmaxx); respond to concerns identified by statistical reports, such as denial reports, missing diagnosis reports, incorrect coding reports, etc.; monitor billing, compliance and coding information for changes pertinent to the practice; serve as a resource for providers, house staff and support staff for information relative to the referral and authorization processes; identify retraining opportunities, and participate in clinic and quality assurance meetings. Minimum Qualifications:

Associate's degree and two (2) years relevant patient financial/insurance services experience in a healthcare related setting or equivalent combination of education and experience required. Working knowledge of medical terminology, familiarity with medical coding, and excellent written/oral communication skills required. Ability to maintain good public relations with patients, visitors, co-workers and other individuals.

Preferred Qualifications:

Previous Ambulatory experience in Outpatient Psychiatry setting preferred. Knowledge of Office of Mental Health regulations preferred. Prior working experience in ambulatory patient care administrative functions including obtaining referrals and insurance authorizations, managing EPIC referral work queues, communicating with outside agencies such as insurance carriers, billing companies and/or other support agencies preferred.

Work Days: Monday-Friday, Days Message to Applicants:   Recruitment  Office: Human Resources Executive Order: Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor's Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.gov.