Specialist Precertification

NewYork-Presbyterian/Weill Cornell Medical Center, an 862-bed medical center affiliated with Weill Cornell Medicine, provides emergency, primary, and specialty care in virtually every field of medicine. Our staff is dedicated to providing the highest quality, most compassionate care and service to each and every one of our patients and their families in a warm and friendly environment.

Responsible for ensuring the timely and accurate processing of pre-certification requests by verifying insurance coverage, obtaining necessary authorizations (via internet, telephone, and/or fax), using/documenting within the Electronic Health Record (EHR) system, and maintaining compliance with payer requirements. This role is essential in minimizing claim denials and supporting a smooth revenue cycle to enhance both patient satisfaction and organizational financial health.

Preferred Criteria

• Bachelor degree

Required Criteria

• High School diploma or GED

• One year of related experience

• Must know insurance verification, obtaining insurance precertification, human relationship skills, and the EHR (Electronic Health Record). Working knowledge or familiarity with medical terminology is preferred, and an understanding of various services and procedures performed by the organization

• Requires proofreading and organizational skills, computer data entry, knowledge of medical terminology, multi-tasking, and time management skills, as well as the EHR (Electronic Health Record). Excellent interpersonal, oral, and written communication skills.

• Must be able to foster teamwork to accomplish projects.

• Proficient in Microsoft Office Programs such as Outlook, Word, and Excel.

• Analytical skills, critical thinking, problem identification, and identifying alternative courses of action.

• Problem identification, identifying alternative courses of action, and resolving conflicts. Notify the supervisor of authorization problems to de-escalate issues.

• Needs to be able to work independently and follow the protocols and processes in place. If decisions are not covered by established protocols currently in place, you will need to notify the appropriate supervisor in regard to appropriate direction. Demonstrates honesty, reliability, and confidentiality.