We have an exciting opportunity to join our team as a Pre-Admissions Specialist.
In this role, the successful candidate will perform duties related to pre-admission of patients to Tisch Hospital. Determine patient and institutional responsibilities according to varied Managed Care and carrier reimbursement plans. Comply 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. Facilitate patient’s and physician’s comprehension of the complexities of the third party payer system as it applies to their cases
Team and Overall Productivity: Effectively perform team-assigned work on time and to standards. Take responsibility for quantity and quality of daily performance requirements. Establish good rapport with all team members. Be a resource to colleagues by sharing information they may need to be more productive. Volunteer assistance to others in completing workload. Assist with training of new staff members. Volunteer for tasks outside of job responsibilities or on special projects assigned by management to help the department achieve its goals.
Communication/collaboration: Communicate and collaborate well with fellow staff members as well as other departments within the institution. Maintain open communication to promote continuous departmental improvement. Participate in departmental meetings by effectively communicating ideas, problems and suggestions to leadership. Communicate with peers and all Hospitals Center staff in a courteous, professional manner. Effectively communicates via email in a professional and clear manner with all Hospitals Center staff.
Judgement/initiative: Use independent judgment and initiative to identify and troubleshoot issues. Identify and inform management of problems or issues before they effect 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.
Tasks include: Work with physicians’ offices, the Office of Managed Care Department, Care Management and Third Party Payors to maximize financial revenues for the Hospitals Center. Be a resource person for physicians’ offices regarding pre-admission process and insurance inquiries. Collaborate with physicians’ offices regarding patient authorization and financial issues. Interpret contracts for pre-existing conditions, co-payments, exclusions, deductibles using expertise and judgment. Utilize the Office of Managed Care and Care Management departments as a resource.
Insure accuracy: Assess the patient’s financial status relative to the Medical Center episode. Validate Epic info for accuracy and completeness with patient and/or physician office staff. Access third party payor information via web or telephone. Accurately create and update patient encounter in Epic hospital account. Perform an accurate financial patient interview when necessary. Notify patients of any financial liabilities in a professional and timely manner. Be available for patient and families when needed.
Self-Management/Performance Standards: Maintain a professional appearance by adhering to departmental dress code, be well-groomed, wear ID badge at all times. Follow all guidelines ethical and proper use of computer equipment, including internet access. Keep workstation tidy and well organized.
Reliability: Demonstrate reliability by maintaining a good attendance/punctuality record. Arrive to work on time and begin to work accordingly. Adhere to departmental guidelines regarding use of sick and vacation time.
Associate’s degree in Health Care or a related field plus experience in Hospital Admissions or Patient Accounts, hospital insures 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.
Demonstrate leadership ability, excellent communication and interpersonal skills required
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 solvingQualified 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 and 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. If you wish to view NYU Langone Health's EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.
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About NYU Langone Health
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.