Job Summary: 

The Outpatient Administrative Specialist will obtain routine and non-routine insurance pre-authorizations, providing insurance companies with procedural and diagnosis codes and pertinent medical records. Contacts patients and schedules appointments when authorization obtained. Processes incoming and outgoing clinic referrals and pre-screens and releases to Finance provider charges, which may include conversing with providers about additional codes or documentation needed. Will manage the denial process and works the insurance denial workqueue, providing additional information to payors in order to attempt to reverse the denial. Communicates with providers and patients about insurance denials, to include advising patients on insurance carrier requirements including services not covered.  Correct insurance registration errors to assure proper flow of the revenue cycle. Assists with standardized patient check-in and check-out procedures including registration activities such as entering and/or verifying demographic and insurance and/or financial information.  Generates routine forms and other documentation.  Understands the need for ABNs and Waiver of Liability forms, explaining them to patient and obtaining their signatures prior to treatment.  Corrects registration errors in the appropriate EPIC workqueue.  Answers phone, prioritizes incoming mail, faxes and correspondence.  Assists in quality improvement activities, including accepting the rotational assignment of representing workgroup on the clinic's Quality Committee.

Minimum Qualifications: 

Associate's Degree and two (2) years of relevant patient financial/insurance services experience in a healthcare related setting or equivalent combination of education and experience required.  Working knowledge of medical and/or dental terminology, familiarity with medical and/or dental coding, and excellent written/oral communication skills required. Ability to multi task all support roles in a high volume setting. Excellent phone customer service and strong computer skills, and keyboarding are necessary.

Preferred Qualifications: 

Working knowledge of computer systems such as EPIC, Word, Outlook, etc. and understanding of insurances and referrals preferred.

Work Days: 

Monday - Friday, Daytime Hours 

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.