Pain Authorization Specialist

Ridge, NY, NY

Full Time

Mid Level

Pain Authorization Specialist
Ridge, NY
Hours: Monday-Friday (8:30am-5pm)

Why Join Us?

At New York Cancer & Blood Specialists (NYCBS), we create an environment where dedicated professionals can thrive. Our team of expert oncologists, hematologists, and compassionate staff work across numerous locations with one shared mission: conquering cancer close to home. Through cutting-edge treatments, innovative research, and a patient-centered philosophy, we are redefining what’s possible in the fight against cancer and blood disorders. Join our growing organization and help us bring healing, hope, and advanced care to the communities we proudly serve.

In this role, you will:

Run and work daily Group Inbox / Business Office Report in OncoEMR for procedure/drug order values: Required, Pending, Auth Issue (Onsite), P2P, and Denied for current date of service as well as 5 days out. All STAT orders are to be worked immediately upon request by the onsite team.
Ensure that all aspects of approval have been checked including prior authorization, pre-determination, and pre-certification before approving the order as meeting NYH policy.
Ensure that all appropriate diagnoses are listed in the patient’s summary for drug/procedure order.
Document in OncoEMR the patient’s treatment plan and approval status.
Must document all steps taken in research/process of the case
Communicate with MD and NP’s if orders need to be changed on treatment plan or to discuss denials and request letter of medical necessity to appeal authorization denials
Any patients that do not have a completed approval status by 4pm EST must be reviewed with management to determine if appointment should be rescheduled.
Work closely with office and third party vendor to ensure authorizations are in place and insurance benefits are accurate.
Maintain and ensure the confidentiality of all patient and employee information at all times.
An authorization specialist will be expected to work when given sufficient notice of required overtime.

We require:

Experience in prior authorizations
High school or GED required.
Experience in pharmacy / authorization field.
Experience working in the healthcare field, preferably in a clinical setting or business office.
Experience in insurance requirements and medical terminology ICD-10 and CPT coding.
Experience in billing practice management systems, electronic medical record systems, Microsoft
Word, and Microsoft Excel.
Excellent verbal and communication skills between co-workers, physicians, management staff,
patients, insurances, outside programs.
Ability to multitask, problem solve, utilize basic math skills and follow complex instructions.
Must have the ability to converse in a calm and friendly manner.
Able to relate and comfort patients during a difficult time.

What we offer:

Salary: Starting at $26/hr based on experience and education
Benefits: Health Insurance on day 1, Dental, Vision, Life Insurance, Short- and Long-term disability, 401k Plan, generous PTO, 8 paid holidays (2 floating)

Join us at NYCBS, where we are making strides in healthcare through innovative and compassionate care.
Visit our website at: Nycancer.com

Follow us on Facebook: NYCBS on Facebook

*New York Cancer and Blood Specialists is an Equal Opportunity Employer.*

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This position is located in Ridge N.Y. Do you live in Long Island N.Y*

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Our mission:

is to provide world-class, patient-centered affordable care to patients with cancer and blood disorders in their communities, close to family and friends.

Pain Authorization Specialist

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