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State University of New York Upstate Medical University
The Authorization Specialist works with providers, patients, ancillary departments, pharmacy and insurance carriers to ensure that all information is coded correctly to obtain authorizations for maximum reimbursements.
Associates Degree and three years relevant patient financial/insurance services experience (preferably in a healthcare setting) or equivalent combination of education and experience. Working knowledge of medical terminology, familiarity with medical coding and written/oral communication skills required. Excellent problem solving skills, computer and keyboarding skills required. This position requires strong knowledge of ICD, CPT, and J codes to effectively communicate all information to insurance carriers. Ability to maintain good public relations with patients, families, co-workers and other individuals as necessary.
Prior experience working with ambulatory patient care administrative functions, collecting/analyzing data, organizing appropriate record keeping systems and outside agencies such as insurance carriers, CMS, billing companies and/or other support agencies preferred. Knowledge of medical billing requirements and ability to recognize insurance fraud/abuse strongly preferred. Experience with medication reimbursement, medications, physician orders and insurance claim submission. Experience with healthcare insurance prior authorization/coding and performing insurance carrier/managed care review preferred.
Monday-Friday, 8:00a-4:30p
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.