• Job Type: Officer of Administration
• Regular/Temporary: Regular
• Hours Per Week: 35
• Salary Range: $61,500-$65,000

Position Summary

Under the direction of the Patient Service Advisor Manager, the College of Dental Medicine is searching for a detailed oriented and knowledgeable Pre-Authorization Specialist.

Responsibilities

• Handle authorization process and obtain pre-certification approvals prior to service.
• Submit pre-authorization requests and follow up with payer to ensure timely approvals. Appraise student providers and supervising faculty of delays related to pre-authorization.
• Assist providers with treatment plan assessment to determine if pre-authorization is required.
• Develop a standardized workflow for the pre-authorization process.
• Provide instruction guidelines on coding and pre-authorization processes to faculty, staff and students.
• Guide and assist providers with writing dental necessity letters.
• Respond and follow-up to patient and insurance inquiries/correspondence.
• Provide leadership team on status updates on authorization and denials.
• Maintain accurate records and reports of pre-certifications request, approvals, and denials.
• Review assigned Epic Dental Work Queue's to ensure all errors are cleared and billing has been submitted in timely fashion.
• Stay current with changes in coding guidelines, regulation and insurance requirements.
• Assess and monitor Article 28 Medicaid billing guidelines and regulations and partner with compliance. officer on corrective action plans related to billing compliance.
• Stay current with changes in coding guidelines, regulation and insurance requirements.
• Collaborate with revenue cycle team via weekly, biweekly, and monthly meetings to review payment and denial trends.
• Collaborate with members of clinic administration on process improvement to help optimize the pre-authorization processes in the clinics.
• Performs other related tasks as assigned.

Minimum Qualifications

• Requires a Bachelor's degree or equivalent in education and experience, plus 3 years of related experience.

Preferred Qualifications

• 1 year of experience working in Article 28 dental facility.
• Familiarity with dental terminology, procedures and diagnoses.
• Epic experience preferred.

Other Requirements

• Must be highly organized and motivated, excellent interpersonal and communication skills needed.
• Excellent verbal and written communication and strong organizational skills.
• Ability to plan ahead and prioritize deadlines.
• Ability to work in a fast-paced environment.

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.