Lead Insurance & Financial Clearance Coordinator

Title: Lead Insurance & Financial Clearance Coordinator  

Location: Lower East Side  

Org Unit: WCINYP Pre-Authorization 

Work Days:  

Exemption Status: Non-Exempt

Salary Range: $31.65 - $35.88  

*As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices 

Position Summary

Under direction, the role involves serving as a resource for new hires and senior staff, identifying opportunities for process improvements, troubleshooting issues, and participating in training and workshops to stay up-to-date on regulations and best practices.

Job Responsibilities

• Serve as a resource for new hires and senior staff, providing guidance and answering questions about preauthorization processes and procedures.
• Assist in training and onboarding new team members, ensuring they have the necessary tools and knowledge to perform their roles effectively. Updates the training manuals. Identifies areas for improvement and building communication.
• Improves overall department and organization efficiency and performance by identifying opportunities to enhance internal processes.
• Participates in all day-to-day activities of the department by providing support and backup as needed. Assist with special projects and initiatives as assigned by leadership.
• Troubleshoots patient and staff issues and escalates difficult situations.
• Responsible for verifying and coordinating insurance benefits for all new or existing patients scheduled for Outpatient Radiology procedures to ensure the insurance carrier covers the necessary functions.
• Review and determine authorization requirements for scheduled services and utilize payer-specific portals to submit prior authorization requests before the service date.
• Ensure that the appropriate procedure code(s), diagnosis code(s), and clinical information are utilized and submitted during the prior authorization process.
• Provide patients with estimated charges when requested. Generate and provides a Good Faith Estimate (GFE) of charges for services provided to an uninsured patient or insured patient who elects not to submit a claim to their health insurance for coverage.
• Manages inbound and outbound phone calls and inquiries. Utilize problem-solving skills to determine the best course of action to resolve any problems resulting from insurance coverage or prior authorizations.

Education

• High School Diploma

Experience

• Associate's and/or bachelor’s degree highly desired.
• Minimum of 2 years working in the medical field.
• 5+ years of experience in medical field a plus.
• One year experience with obtaining and verifying pre-authorizations with various Managed Care Companies and billing/coding experience preferred.
• Experience working in a Radiology office or Department a plus.
• Working knowledge of IDX, EPIC, or Medicalis helpful.

 

Knowledge, Skills and Abilities

• Demonstrated organizational skills and ability to pay close attention to detail.
• Ability to multi-task and self-prioritize work.
• Team player.
• Ability to demonstrate excellent customer service skills in person, via email and on the telephone.
• Basic computer experience required for data entry and troubleshooting

Licenses and Certifications

Working Conditions/Physical Demands

• Standard office work
• Role may require the ability to work flexible hours, which may include earl morning and/or late nights.

 

 

 

 

 

Weill Cornell Medicine is a comprehensive academic medical center that is committed to excellence in patient care, scientific discovery, and the education of future physicians and scientists in New York City and around the world. Our doctors and scientists - faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and the Weill Cornell Physician Organization - are engaged in world-class clinical care and cutting-edge research that connect patients to the latest treatment innovations and prevention strategies. Located in the heart of the Upper East Side's scientific corridor, Weill Cornell Medicine's powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U.S. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey. Our medical practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian/Lower Manhattan Hospital, NewYork-Presbyterian Hospital/Brooklyn Methodist Hospital, NewYork-Presbyterian Hospital/Westchester Behaviora