SUNY Upstate Medical University Outpatient Administrative Specialist in Syracuse, New York
SUNY Upstate is seeking an Outpatient Administrative Specialists (OAS) to join a new Integrated Behavioral Health (BH) Care program, which is set to launch with the completion of a new state of the art clinical space at the Nappi Wellness Institute in summer 2023.
The Outpatient Administrative Specialist will work for the standalone Behavioral Health Clinic as well as assisting the providers and staff embedded in other Nappi Clinics. This position will coordinate training and assist other Outpatient Administrative Specialists in pre-authorization for behavioral healthcare services. The incumbent will serve as the Nappi BH service contact for the coordination of primary care curbside consults and STAT BH service needs. This position will manage templates and complex schedules of BH providers. The OAS will back up the Clinic front desk clerk. The Outpatient Administrative Specialist is responsible for obtaining insurance referrals and authorizations for outpatient office visits, diagnostic tests and lab work; working with patients, families, providers, ancillary departments and insurance carriers to ensure all encounters are appropriate for maximum reimbursement, minimal denials and adherence to carrier rules. Works with/advises patients on insurance requirements/services not covered. Communicates authorization, benefits and limitations to providers and patients. The Outpatient Administrative Specialist will work with various computer programs (EPIC, etc.); respond to concerns identified by statistical reports, such as denial reports, missing diagnosis reports, incorrect coding reports, etc.; monitor billing, compliance and coding information for changes pertinent to the practice; serve as a resource for providers, house staff and support staff for information relative to the referral and authorization processes; identify retraining opportunities, and participate in clinic and quality assurance meetings.
Associate's degree and two (2) years relevant patient financial/insurance services experience in a healthcare related setting or equivalent combination of education and experience required. Working knowledge of medical terminology, familiarity with medical coding, and excellent written/oral communication skills required.
Prior working experience or desire to work within dynamic collaborative team within Ambulatory setting. Prior experience with coordinating, overseeing and performing a wide variety of administrative and program support activities.
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Recruitment Office: Human Resources
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