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Billing and Prior Authorization Specialist

Optum

Optum NY/NJ is seeking a Billing and Prior Authorization Specialist to join the team in Lake Success, NY. The position involves working cooperatively with the care team to support financial, clinical, and service goals, ensuring excellent customer service and adherence to Lean processes.

Primary responsibilities include updating insurance information, scheduling infusion treatments per medication plans, filing records, responding to phone inquiries, managing referrals and appointments, verifying insurance eligibility and authorization, discussing balances and co-pays with patients, utilizing EHR for communication and administrative tasks, managing claims denial, interacting with customers for billing accuracy, providing input on billing policies, educating customers on payment methods, monitoring accounts receivable, knowledge of diagnosis and CPT codes, managing appeals, and other assigned duties.

Schedule: 37.5 hours/week, Monday through Thursday 9:00 am to 5:00 pm, Friday hours to be determined.

The role is based at 2 Ohio Drive, Suite 103, Lake Success, NY 11042.

The position requires 1+ years in a medical office role involving insurance verification, pre-authorization, and claims review, plus computer proficiency and preferably experience with EPIC EHR, medical terminology, CPT and diagnosis codes.

Skills needed include independence, accountability, strong organizational skills, multitasking, empathy, ability to work well under pressure, and excellent communication.

Pay rate is hourly ($17.98 to $32.12/hr) based on experience and local labor market. Benefits include PTO, holidays, health plans, disability insurance, 401(k), education reimbursement, discounts, and more.

Optum is committed to diversity, equitable care, and a drug-free workplace with pre-employment drug testing.

Requirements & Qualifications
  • High School Diploma or GED
  • 1+ years computer proficiency, especially Microsoft Office
  • 1+ years experience in medical office duties including insurance verification, prior authorization, claims review, and medication schedule management
  • Preferred: experience with electronic health records (EPIC), medical terminology, CPT and diagnosis coding
  • Ability to work independently with good judgment and accountability
  • Strong organizational and time management skills
  • Ability to multitask and prioritize
  • Empathy and kindness towards patients
  • Ability to work under pressure in a fast-paced environment
  • Excellent verbal and written communication skills
Benefits & Perks
  • Paid Time Off and 8 Paid Holidays
  • Medical plan options with Health Spending or Saving Accounts
  • Dental, Vision, Life, AD&D Insurance
  • Short-term and Long-term Disability coverage
  • 401(k) Savings Plan and Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts and Assistance Program
  • Employee Referral Bonus
  • Voluntary benefits (pet insurance, legal insurance, LTC Insurance, etc.)

Location

New York, US

Employment Type

Full-time

Experience Level

Associate

Remote work allowed

No

Posted

3 weeks ago

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