Strength Through Diversity

Ground breaking science. Advancing medicine. Healing made personal.

Pre-Certification Counselor-150 East 42nd Street

Patient Financial Services Self Pay/Financial Intake- Insurance Verification and Authorization

The Pre-Certification Counselor interacts daily with patients, payers, and clinical staff to ensure that services are financially cleared prior to service provision. Responsible for the financial screening and counseling for services provided in Hospital Based (Article 28) departments for both the technical and professional components. This includes ensuring all required demographic, financial, referrals, authorizations and other registration data are collected prior to treatment, verified and communicated appropriately

Roles & Responsibilities:

• Responsible for the insurance verification for all encounters for both the hospital and physician.
• Referral coordination, pre-certification, pre-authorization and benefit screening. Maintains updates of outcome through multiple systems.
• Responsible for the drug authorizations and financial verifications, as well as tracking authorization counts and re-authorizing as required by each payer.
• Responsible for notification to patients on all out of pocket expenses and working with the front desk to ensure collection of co-payments prior to treatment. Assists patients with any state/federal/pharmacy assistance programs to help cover treatment costs.
• Utilizes various eligibility systems and websites to obtain benefits, must be able to interpret all coding. Contacts various payers and physician offices to obtain authorizations, benefits and referrals.
• Ensures all required demographic, financial, referral/authorization, clinical and other registration data is collected, verified, inputted and communicating appropriately with patient.
• Responsible for providing in advance to registration, all patient payment responsibilities before the scheduled visit. These payment responsibilities are for both the hospital and physician.
• Coordinates activities with specific physician offices, service sites and ancillary departments.
• Responsible for Financial Counseling and Customer Service for inquires made by patients, physicians, payers and clinical staff. These inquiries can be in regards to coverage, benefits, payment plans, outstanding bills and any other questions.
• Engages in cross-training to support all aspects of this unit.
• Schedule can vary according to the needs of the assigned area.
• Special projects as assigned by Manager and Senior Director.

Requirements:

• Education: HS/GED; Associates Degree preferred
• Experience: 1 year Hospital/Physician practice experience or billing experience preferred.
• Knowledge of health insurance payer requirements a plus.
• Knowledge of Microsoft Excel and Word (35 WPM min).

Strength Through Diversity

The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by:

• Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential
• Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination
• Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers

We work hard to acquire and retain the best people and to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong, and are able to professionally advance. We share the belief that all employees, regardless of job title or expertise, contribute to the patient experience and quality of patient care.

Explore more about this opportunity and how you can help us write a new chapter in our history!

Who We Are

Over 42,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.

Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospitals, including Mount Sinai Beth Israel, Mount Sinai Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.

The Mount Sinai Health System (MSHS) provides equal employment opportunity to all its employees and applicants for employment without unlawful discrimination on the basis of their actual or perceived race, creed, color, religion, national origin, sex, gender, gender expression, gender identity, age, disability, marital or parental status, sexual orientation, veteran, immigration, citizenship, or other protected status.

EOE including Veterans and Disabled

Compensation

The Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $23.61 - $24.90 Hourly. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.