NYU Langone Hospital-Suffolk is a 306-bed medical center, providing care to residents of eastern Long Island. The hospital facility is home to the Knapp Cardiac Care Center -an advanced heart disease diagnostic and treatment facility-as well as a modern ambulatory surgical pavilion with specialized services including women's imaging, a sleep laboratory, and bariatric surgery. Our Provisional Level 2 Trauma Center delivers comprehensive and specialized care for patients with traumatic injuries. The Stroke Center at NYU Langone Hospital-Suffolk is designated by the New York State Department of Health as a Primary Stroke Center, with expert neurologists available to provide treatment 24 hours a day, 7 days a week. Additionally, NYU Langone Hospital-Suffolk has multiple outpatient sites, including an outpatient wound care center, a hemodialysis center, and various primary care and specialty offices. For more information, go toNYU Langone Hospital - Suffolk , and interact with us onLinkedIn,Glassdoor,Indeed, https://www.facebook.com/NYULangone/ Facebook ,Twitter, https://www.youtube.com/c/nyulangonehealth YouTube , and https://www.instagram.com/nyulangone Instagram .
Position Summary:
We have an exciting opportunity to join our team as a Financial Clearance Associate - Full Time, Days - FIN-Insurance Verif/Cust Svc - Full-Time - 09:00 AM- 05:00 PM.In this role, the successful candidate Under the general direction of the RCO Director and the assigned RCO Associate Director/Sr Manager/Manager/ Supervisor the RCO Financial Clearance Associate FCA is responsible for performing accurate and timely insurance clearance functions pre and post service to ensure maximum hospital reimbursement and mitigate insurance denials Health system responsibilities for the FCA include but are not limited to: 1 verifying insurance eligibility and determining patients insurance coverage and insurance authorization requirements 2 obtaining and documenting pre authorizations and pre certifications 3 verifying coverage levels 4 utilizing the Epic Estimate tool to calculate patients estimated hospital financial responsibility and ensuring OOP amounts are communicated to the patient pre service 5 working cases timely and efficiently from the Epic Work Queues/DAR as assigned 6 collecting pre service time of payments and 7 providing exceptional customer service to both internal and external stakeholders and facilitating RCO and patient financial needs Supports and demonstrates the Philosophy/Mission of LICH in the performance of duties and representation
Job Responsibilities:
This position is responsible and accountable for the timely and accurate insurance clearance of pre and post inpatient and outpatient accounts from Epic Work Queues as assigned.
Performs insurance benefits verification to confirm eligibility for scheduled or prospective services.
Reviews for appropriate coordination of benefit and identifies discrepancies prior to clearance.
Determines insurance authorization requirements for services scheduled or received.
Ensures all scheduled services are authorized and appropriate notification and/or referral is obtained prior to the date of service to ensure payment for services.
Ensures clear and timely documentation of all insurance clearance activities and outcomes, incl uding authorization information in Epic . Performs all required follow-up to secure autho
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