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- Tasks: Ensure accurate insurance coverage and authorisations for surgical and outpatient procedures.
- Company: Join a leading healthcare provider dedicated to quality patient care.
- Benefits: Competitive hourly wage, full-time hours, and opportunities for professional growth.
- Why this job: Make a difference in patient care while developing your skills in a dynamic environment.
- Qualifications: High school diploma required; 3 years of related experience preferred.
- Other info: Ideal for detail-oriented individuals with strong communication skills.
The Health Insurance and Authorization Specialist is responsible for assessing and performing quality control functions for all preadmission visits on surgical inpatient, short stay 23 (SS23), Endo and ambulatory procedures ensuring all pertinent information is on file and accurately documented. These activities include:
- Reviewing diagnosis and history for correct insurance coverage.
- Insurance eligibility and coverage verification using the three patient identifiers.
- Confirming prior authorization is on file for the correct level of care.
- Inquiring on prior auth denials and working with the Provider’s office to resolve.
- Requesting estimated costs and collecting deposits for non-covered services.
- Ensuring appropriate medical justification is documented for out-of-network payers.
- Referring self-pay patients to Financial Case Management (FCM) for Medicaid assessment or Financial Assistance.
- Reviewing and validating MSP questions.
- Monitoring Medicare days for exhausted benefits.
- Identifying and resolving coordination of benefits discrepancies.
- Notifying Utilization Management of additional clinical requests.
Salary Range: £19.62 - £26.49 an hour. The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
Job Requirements:
- Education: High school Diploma or equivalent required. Associate degree preferred in related discipline (admitting/registration/patient billing/insurance); or equivalent experience.
- Experience: Minimum of 3 years of related experience preferably in a hospital setting, medical office billing and/or knowledge of third-party insurance regulations.
- Skills: Require high degree of professionalism and motivation with excellent communication and customer service skills, and medical terminology. Good interpersonal and telephone skills. Detail oriented. Computer, copier and FAX skills.
Health Insurance & Authorization Specialist I in Rochester employer: University of Rochester
Contact Detail:
University of Rochester Recruiting Team
StudySmarter Expert Advice 🤫
We think this is how you could land Health Insurance & Authorization Specialist I in Rochester
✨Tip Number 1
Network like a pro! Reach out to folks in the health insurance field, especially those who work in hospitals or medical offices. You never know who might have the inside scoop on job openings or can put in a good word for you.
✨Tip Number 2
Prepare for interviews by brushing up on your knowledge of insurance regulations and medical terminology. We want you to feel confident discussing your experience and how it relates to the role of a Health Insurance & Authorization Specialist.
✨Tip Number 3
Don’t just apply anywhere—apply through our website! It’s the best way to ensure your application gets seen by the right people. Plus, it shows you’re genuinely interested in joining our team.
✨Tip Number 4
Follow up after your interview! A quick thank-you email can go a long way in making a lasting impression. It shows you’re enthusiastic about the position and keeps you fresh in their minds.
We think you need these skills to ace Health Insurance & Authorization Specialist I in Rochester
Some tips for your application 🫡
Tailor Your CV: Make sure your CV highlights relevant experience in health insurance and authorization. We want to see how your skills match the job description, so don’t be shy about showcasing your expertise in medical billing and third-party insurance regulations.
Craft a Compelling Cover Letter: Your cover letter is your chance to shine! Use it to explain why you’re the perfect fit for the Health Insurance & Authorization Specialist role. We love seeing enthusiasm and a clear understanding of the responsibilities outlined in the job description.
Show Off Your Attention to Detail: Since this role requires a high degree of accuracy, make sure your application is free from typos and errors. We appreciate candidates who take the time to double-check their work, as it reflects the attention to detail we value at StudySmarter.
Apply Through Our Website: We encourage you to apply directly through our website. It’s the easiest way for us to receive your application and ensures you’re considered for the role. Plus, you’ll get to explore more about what we do and our company culture!
How to prepare for a job interview at University of Rochester
✨Know Your Stuff
Make sure you brush up on health insurance terminology and the specific responsibilities of a Health Insurance & Authorization Specialist. Familiarise yourself with common insurance regulations and processes, as well as the types of procedures you'll be dealing with. This will show that you're not just interested in the job, but that you understand it too.
✨Prepare for Scenario Questions
Expect to be asked about how you'd handle specific situations, like resolving prior auth denials or coordinating benefits discrepancies. Think of examples from your past experience where you've successfully navigated similar challenges. This will help demonstrate your problem-solving skills and your ability to work under pressure.
✨Show Off Your Communication Skills
Since this role requires excellent communication and customer service skills, be ready to showcase these during the interview. Practice articulating your thoughts clearly and confidently. You might even want to prepare a few anecdotes that highlight your interpersonal skills, especially in a medical or insurance context.
✨Ask Smart Questions
At the end of the interview, don’t forget to ask insightful questions about the team, the company culture, or specific challenges they face in the role. This shows that you're genuinely interested and engaged. Plus, it gives you a chance to assess if this is the right fit for you too!