Columbia University
Pre-Authorization Specialist
Columbia University, New York, New York, us, 10261
Job Type: Officer of AdministrationRegular/Temporary: RegularHours Per Week: 35Salary Range: $61,500-$65,000
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.
Position SummaryUnder the direction of the Patient Service Advisor Manager, the College of Dental Medicine is searching for a detailed oriented and knowledgeable Pre-Authorization Specialist.ResponsibilitiesHandle authorization process and obtain pre-certification approvals prior to service.Submit pre-authorization requests and follow up with payer to ensure timely approvals. Appraise student providers and supervising faculty of delays related to pre-authorization.Assist providers with treatment plan assessment to determine if pre-authorization is required.Develop a standardized workflow for the pre-authorization process.Provide instruction guidelines on coding and pre-authorization processes to faculty, staff and students.Guide and assist providers with writing dental necessity letters.Respond and follow-up to patient and insurance inquiries/correspondence.Provide leadership team on status updates on authorization and denials.Maintain accurate records and reports of pre-certifications request, approvals, and denials.Review assigned Epic Dental Work Queue's to ensure all errors are cleared and billing has been submitted in timely fashion.Stay current with changes in coding guidelines, regulation and insurance requirements.Assess and monitor Article 28 Medicaid billing guidelines and regulations and partner with compliance. officer on corrective action plans related to billing compliance.Stay current with changes in coding guidelines, regulation and insurance requirements.Collaborate with revenue cycle team via weekly, biweekly, and monthly meetings to review payment and denial trends.Collaborate with members of clinic administration on process improvement to help optimize the pre-authorization processes in the clinics.Performs other related tasks as assigned.
Minimum QualificationsRequires a Bachelor's degree or equivalent in education and experience, plus 3 years of related experience.
Preferred Qualifications1 year of experience working in Article 28 dental facility.Familiarity with dental terminology, procedures and diagnoses.Epic experience preferred.
Other RequirementsMust be highly organized and motivated, excellent interpersonal and communication skills needed.Excellent verbal and written communication and strong organizational skills.Ability to plan ahead and prioritize deadlines.Ability to work in a fast-paced environment.
Equal Opportunity Employer / Disability / VeteranColumbia University is committed to the hiring of qualified local residents.
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.
Position SummaryUnder the direction of the Patient Service Advisor Manager, the College of Dental Medicine is searching for a detailed oriented and knowledgeable Pre-Authorization Specialist.ResponsibilitiesHandle authorization process and obtain pre-certification approvals prior to service.Submit pre-authorization requests and follow up with payer to ensure timely approvals. Appraise student providers and supervising faculty of delays related to pre-authorization.Assist providers with treatment plan assessment to determine if pre-authorization is required.Develop a standardized workflow for the pre-authorization process.Provide instruction guidelines on coding and pre-authorization processes to faculty, staff and students.Guide and assist providers with writing dental necessity letters.Respond and follow-up to patient and insurance inquiries/correspondence.Provide leadership team on status updates on authorization and denials.Maintain accurate records and reports of pre-certifications request, approvals, and denials.Review assigned Epic Dental Work Queue's to ensure all errors are cleared and billing has been submitted in timely fashion.Stay current with changes in coding guidelines, regulation and insurance requirements.Assess and monitor Article 28 Medicaid billing guidelines and regulations and partner with compliance. officer on corrective action plans related to billing compliance.Stay current with changes in coding guidelines, regulation and insurance requirements.Collaborate with revenue cycle team via weekly, biweekly, and monthly meetings to review payment and denial trends.Collaborate with members of clinic administration on process improvement to help optimize the pre-authorization processes in the clinics.Performs other related tasks as assigned.
Minimum QualificationsRequires a Bachelor's degree or equivalent in education and experience, plus 3 years of related experience.
Preferred Qualifications1 year of experience working in Article 28 dental facility.Familiarity with dental terminology, procedures and diagnoses.Epic experience preferred.
Other RequirementsMust be highly organized and motivated, excellent interpersonal and communication skills needed.Excellent verbal and written communication and strong organizational skills.Ability to plan ahead and prioritize deadlines.Ability to work in a fast-paced environment.
Equal Opportunity Employer / Disability / VeteranColumbia University is committed to the hiring of qualified local residents.