Revenue Specialist Surgical Services Poughkeepsie, NY HybridRemote
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Job Location:
Poughkeepsie, NY - USA
Hourly Salary:
$ 19 - 37
Posted on:
21 hours ago
Vacancies:
1 Vacancy
Department:
Job Summary
Description
Title: Revenue Specialist - Surgical Services - Poughkeepsie NY - Hybrid/Remote - Monday through Friday
Summary:
Manages office-level authorizations for STAT treatments ordered diagnostic tests new patient referrals and referral loop closure to support timely patient care and smooth clinic operations.The ideal candidate is patient-focused an effective communicator self-starter and has a keen attention to detail.
Responsibilities:
1. Processes STAT treatment authorizations ensures urgent treatment orders are accurately submitted tracked and approved within required timeframes to avoid delays in patient care.
2. Resolves Authorization Denials & Resubmissions Coordinates order adjustments and authorizations requiring peer-to-peer review confirming documentation accuracy and payer requirements. Investigates denial reasons works with providers for supporting documentation and resubmits requests to secure approval. Provides timely updates to providers scheduling staff and patients on authorization approvals denials or requirements for additional information.
3. Manages New Patient Referrals Processes insurance authorizations for all new patient referrals ensuring coverage and financial clearance before scheduling.
4. Referral Loop Closure & Documentation Closes referral loops per compliance standards and strengthen referral relationships/patterns by fully documenting outcomes ensuring provider-to-provider communication is completed and logged.
5. Improves Access Through New Patient Scheduling Oversight- Review schedule and adjust New Patient visits appropriately for surgeons and APP/APRNs based on practice guidelines.
6. Patient Communication & Support Provides clear compassionate communication to patients regarding insurance requirements next steps and any delays.
7. Maintains Compliance with Payer Regulations Stays informed on insurance policies authorization criteria and regulatory changes impacting workflows.
8. Documentation & EMR Management ensures all authorization notes approvals and correspondence are accurately captured in the EMR for compliance and audit readiness. Verifies insurance benefits and updates EMR records to ensure all financial and authorization data remains current.
9. Collaborates with Clinical & Administrative Teams works closely with front desk medical assistants nurses and providers to ensure smooth workflow and prioritize urgent cases.
10. Assists with Monthly Reporting Supports creation of authorization metrics denial trends and turnaround times for leadership review as needed.
11. Identifies Workflow Gaps & Process Improvements Suggests and implements improvements to streamline authorization management and reduce administrative bottlenecks.
12. Performs Other Related Administrative Duties provides general clerical support as needed to maintain effective daily operations.
13. Maintains and Models Nuvance Health Values.
14. Demonstrates regular reliable and predictable attendance.
15. Performs other duties as required.
Other Information:
Prior insurance knowledge and medical practice billing experience preferred.
Salary Range: $19.54 - $37.94 Hourly
Required Experience:
IC
About Company
Our hospitals, medical practice and care centers are located throughout New York’s Hudson Valley and Western Connecticut. At every location, you’ll find excellent convenient care, a personalized approach, a connected team, and access to our network of doctors. Find care now.
