We have an exciting opportunity to join our team as a Pre-Admissions Specialist.
Position Summary: In this role, the successful candidate will be performing duties related to pre-admission of patients to Tisch Hospital, determines patient and institutional responsibilities according to varied Managed Care and carrier reimbursement plans.Complies with third party payor regulations and Managed Care networks Systems requirements (i.e.global versus per diem vs. DRG reimbursements). Accurately obtain all financial information to properly record episode and to maximize reimbursement for the medical center. Assist both patients and physicians to comprehend the complexities of third party payer system as it applies to their cases
Contribution to Team & Overall Productivity. Components of Responsibility/Tasks:: Effectively performs team-assigned work on time and to standards. Acknowledges responsibility for quantity and quality of daily performance requirements. Establishes a good rapport with all team members. Resource to colleagues by sharing information they may need to be more productive. Volunteers assistance to others in completing workload. Assists with training new staff members. Volunteers for tasks outside of job responsibilities or on special projects assigned by management to help the department achieve its goals.
Communicates and collaborates well with fellow staff members as well as other departments within the institution. Components of Responsibility/Tasks: Maintains open communication to promote continuous departmental improvement. Participates in departmental meetings by effectively communicating ideas, problems and suggestions to leadership. Communicates with peers and all Hospitals Center staff in a courteous, effective and professional manner. Effectively communicates via email in a professional and clear manner with all Hospitals Center staff.
Uses independent judgment and initiative to identify and troubleshoot issues. Components of Responsibility/Tasks: Identifies and informs management of problems or issues before they affect patients and/or departmental daily operations. Handles all patient and/or Hospitals Center staff complaints in a helpful way and to the satisfaction of management. Refers issues to management in cases when the issue is not resolvable at your level.
Works with physicians offices, the Office of Managed Care Department, Care Management and Third Party Payors to maximize financial revenues for the Hospitals Center. Components of Responsibility/Tasks: Is a resource person for physicians offices regarding pre-admission process and insurance inquiries. Collaborates with physicians offices regarding patient authorization & financial issues. Interprets contracts for pre-existing conditions, co-payments, exclusions, deductibles using expertise and judgment. Utilizes the Office of Managed Care & Care Management departments as a resource.
Assesses the patients financial status relative to the Medical Center episode. Components of Responsibility/Tasks: Validates Epic info for accuracy and completeness with patient and/or physician office staff. Accesses third party payor information via web or telephone. Accurately creates and updates patient encounter in Epic hospital account. Performs an accurate financial patient interview when necessary. Notifies patients of any financial liabilities in a professional & timely manner. Is available for patient and families when needed.
Maintains a professional appearance by; adhering to departmental dress code; well-groomed; wears ID badge at all times. Follows all guidelines ethical and proper use of computer equipment, including internet access. Keeps workstation tidy and well organized.
Demonstrates reliability by maintaining a good attendance/punctuality record. Arrives to work on time and begins to work accordingly. Adheres to departmental guidelines regarding use of sick & vacation time.
Minimum Qualifications: To qualify you must have a Associates degree in Health Care or a related field plus experience in Hospital Admissions or Patient Accounts, hospital insurance carriers, Managed Care Services, or an equivalent combination of education and experience. Knowledge of third party payor regulations, Managed Care network provider systems,and Diagnostic Related Group (DRGs) required. Demonstrates leadership ability, excellent communication and interpersonal skills required
Preferred Qualifications: College Degree and/or Some college education with a minimum of 2 years in a Healthcare/Hospital setting. Customer service experience. Evidence of good interpersonal skills, effective communication skills and creative problem solving
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military or veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
NYU Langone Health, a world-class patient-centered integrated academic medical center, is one of the nation's premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals – Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, one of only five hospitals in the nation dedicated to orthopaedics and rheumatology; and Hassenfeld Children's Hospital, a comprehensive pediatric hospital supporting a full array of children's health services across the medical center – plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center's tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research. For more information, go to www.nyulangone.org.