SB CLINICAL PRACTICE MANAGEMENT PLAN INC · 2 weeks ago
Authorization & Billing Support Specialist, Senior
Stony Brook, NY
Full-time
Onsite
Mid, Senior Level
$24.15/hr - $30.18/hr
3+ years expSB Clinical Practice Management Plan Inc is seeking an Authorization & Billing Support Specialist, Senior to assist the Medical Coding Manager with the day-to-day operations of the coding unit. The role involves providing administrative and clinical office support, acting as a liaison between patients and physicians regarding insurance policies and procedures, and managing various billing and coding tasks.
Hospital & Health Care
Responsibilities
Validate patient insurance
Appeal denials, write appeal letters giving medical necessity and provide medical records to support the appeal
Review Task Manager regularly, respond to denials and open encounters posted to Task Manager, make corrections
Administrate insurance websites, oversee passwords
Collect insurance referrals and prior authorization for testing and procedures. Authorize and manage Neuro Psychiatric Testing. Ensure the approvals for the authorizations are in the EMR and CERNER systems
Promote department goals by training team members on insurance policies. Stay current on guidelines set by insurance. Educate staff and providers on insurance policies
Act as a resource with regards to insurance and coding policies and procedures to both staff and providers
Act as liaison and problem solver between physician and staff with regards to coding and charge entry
Provide resolution to coding related issues based on industry coding best practices
Analyze, code and abstract information for the purpose of assigning and entering appropriate and consistent diagnoses and procedure codes for reimbursement
Resolve discrepancies on coding related issues
Analyze and understand reasons for denials
Document trends of denials to share with department, and provide in-service for continuous improvement. This includes changes of internal system, carrier updates, functions, and duties & processes impacting billing cycles
Inform staff and self pays of UH financial aid applications and Medicaid applications
Ensure all data are accurately documented in the EMR and scanned into CERNER
Provide data to CPMP Patient Accounts as requested for patient inquiries
Initiate Source Document to add new CPT Codes to Patient Keeper and Cerner
Proactively identify and implement opportunities for process improvements
Attend meetings and all other duties as assigned
Qualification
Required
Associate's degree; in lieu of degree, an additional 2 years of experience working in a physician practice or healthcare environment
Three (3) years of full-time experience working in a physician practice or healthcare environment
Knowledge of insurance verification/update, scheduling, assist with prior pre-authorization or obtaining referrals process experience
Strong organizational and communication skills (both verbal and written)
Excellent attention to detail
Exceptional telephone etiquette
Proficient in Microsoft Office
Preferred
Bachelor's Degree
EMR experience - Cerner/IDX
Experience with patient scheduling
Company
SB CLINICAL PRACTICE MANAGEMENT PLAN INC
At SB Clinical Practice Management Plan, Inc.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Lisa Layton
Chief Financial Officer
Company data provided by crunchbase