Authorization Specialist - SB Clinical Practice Management

Authorization Specialist - Stony Brook Family and Preventive Medicine, UFPC  

Location: Stony Brook, NY

Schedule: Full Time

Days/Hours: Monday - Friday; 9AM - 5 PM 

Pay: $20.44 - $25.55

Our compensation philosophy aims to provide marketable compensation programs and to compensate employees based on relevant experience and education. Individual compensation discussions begin during the hiring process and may occur during job review and promotional opportunities. Salaries vary depending on experience, education and current market for the position. Human Resources determines the external and internal equitable salary for each employee.

SUMMARY: To provide general administrative and clinical office support.  Acts as a liaison between patients and physicians. 

Job Responsibilities:

• Access the referrals and authorizations via the internet.
• Update and inquire as to those insurances that are not on the internet.
• Obtain authorizations for CAT scans and other radiological procedures.
• Validate patient insurance.
• Contact patients concerning referrals or down payment for self pays.
• Inform self pays of UH financial aid applications and Medicaid applications.
• Communicate with physicians, NP/PA, colleagues, patients, and insurance carriers, concerning referrals or issues with obtaining referrals.
• Ensuring the approvals for the authorizations are in the EMR and CERNER systems.
• Ensure all data are accurately documented in the EMR and scanned into CERNER.
• All other duties as assigned.

Required Qualifications:  

• High School diploma/GED.
• One (1) year of administrative experience in a medical office setting.
• Prior pre-authorization or obtaining referrals process experience.
• Strong organizational and communication skills (both verbal and written).
• Excellent typing skills and friendly telephone etiquette.
• Microsoft Office proficiency.

Preferred Qualifications: 

• EMR experience.
• Experience with patient scheduling.
• Experience with managed care companies.
• Bilingual speaking.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to communicate with patients, staff and medical providers. The employee must be able to exchange accurate information in these situations. This position is largely sedentary and requires the employee to remain stationary for a majority of the day. Any additional physical demands will be outlined and provided by management. 

The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of CPMP. 

StaffCo is a Professional Employer Organization, commonly referred to as a PEO, duly organized and registered under the New York Professional Employer Organization law. StaffCo and SUNY have entered into a professional employer agreement under which StaffCo is the employer of Stony Brook Clinical Practice Management Plan employees and responsible for all aspects of employment, including hirings, promotions, disciplines, terminations, the day-to-day direction and supervision of work, as well as labor relations and collective bargaining. StaffCo is fully responsible for providing all payroll and human resources services, including the payment of wages, collecting and reporting payroll taxes and maintaining any and all employee benefits.  SUNY Stony Brook Hospital is responsible for the operation of the hospital and provision of health care and is the co-employer as is necessary to conduct its responsibilities and for related licensure, regulatory or statutory requirements and obligations.    

Given StaffCo’s employment responsibilities, it is deemed the “employer” for employment and labor law purposes.  Thus, the employees are private sector employees of StaffCo, not public sector employees of SUNY.  The private sector nature of the StaffCo employees has been approved by NYS Civil Service and upheld in a decision by the US National Labor Relations Board. 

CPMP provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity or expression, or any other legally protected status.  This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall and transfer, leaves of absence, compensation and training.

CPMP expressly prohibits any form of workplace harassment based on race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity, or any other legally protected status.  Improper interference with the ability of CPMP’s employees to perform their job duties may result in discipline up to and including discharge.