WHY CHOOSE TO JOIN US?

WE VALUE OUR TEAM!

When you come to work for Cayuga Medical Associates, you join a growing multispecialty physician group practice based in the heart of the Finger Lakes in upstate New York, with more than 22 specialties located in Tompkins, Cortland, and Schuyler Counties. Partnering with Cayuga Medical Center, we strive to provide the best patient care in our region. Our commitment to service excellence sets us apart. Our Cornerstones: Patient-Centered Excellence, Teamwork, Safety, Respect, and Professionalism, guide us as we provide care for our community.

As a part of those Cornerstones, it's very important to us that we create a work environment where people feel welcomed, comfortable, valued for what they bring to the organization, and recognized for their contributions. It goes beyond salary and benefits. We work hard to develop an environment and culture that attracts top-quality talent. That is what sets Cayuga Medical Associates apart.

• We offer a very competitive compensation and benefits package including sign-on bonuses for eligible positions, as well as liberal paid time-off
• Our full-time and our benefited part-time employees receive the same benefits package (paid time-off benefits are prorated for part-timers)
• Health insurance coverage becomes effective within four weeks of your start date.
• PTO is available to use immediately!
• Tuition reimbursement is available for career-related education.

What's the role?

The Prior Authorization Specialist supports clinical staff and providers by working effectively with insurance companies to obtain prior authorization for medications, diagnostic testing, and procedures.

What you'll do:

• Completes insurance verification with appropriate documentation in the billing system.
• Obtains prior authorizations as required by payer source, including procurement of needed documentation by working with clinical staff and insurance carrier. Obtain all authorizations via phone, web or fax with proper documentation to support claim appeal if necessary.
• Performs chart review/abstraction to obtain necessary documentation to complete pre-authorization/pre-certification of test/procedure/service.
• Tracks denials for no precertification/authorization to find root cause and prevent denial in the future.
• Assists with appeals for services that the insurance carrier deems as not authorized/pre-certified or notification was not complete.
• Works independently and responsible for timely completion of assigned functions.
• Backup for Patient Services Representative
• Other duties as assigned.

Our ideal candidate will have:

• Knowledge of modern office equipment
• Interpersonal/human relations skills
• Organizational skills
• Telephone etiquette skills
• Ability to maintain records and files
• Ability to operate business computer
• Ability to maintain confidentiality
• 1-2 years of previous medical office experience utilizing medical terminology, medical coding and prior authorization experience is preferred.
• Basic knowledge of Microsoft Office required.
• Previous experience with an electronic health record or medical office software required.
• Ability to demonstrate strong customer service skills.
• Ability to effectively enter information into a variety of computer programs, to include insurance websites.
• Ability to understand and apply guidelines, policies and procedures.
• Ability to interact effectively with patients, physicians, staff, and members of other health care entities.
• Ability to communicate effectively with people of diverse professional, educational and lifestyle background.
• Strong interpersonal skills.
• Strong computer skills.
• Ability to work as a team member.
• Strong verbal and written communication skills.

• Please note, not all of the listed skills are necessary to be qualified or considered for this role.

Physical requirements:

• Sitting- 90%
• Standing- 10%
• Reaching- 20%
• Bending- 5%
• Lifting- must be able to lift 40 lb.

Working environment:

• Hybrid position: the majority of work is remote with the expectation to be onsite when needed (with sufficient advanced notice).
• Pleasant conditions; comfortable indoor climate with suitable equipment and tools to carry out the responsibilities of the job.
• Persons in this job may be exposed to communicable disease through patient care and interaction.

What does CMA offer?

CMA offers an agile, inclusive, and supportive culture where every employee is respected. CMA is based in beautiful Ithaca, NY where nature abounds and a strong sense of community thrives. Ithaca is home to two esteemed institutes of higher education, Ithaca College and the world-renowned Cornell University. Ithaca offers four dynamic seasons for outdoor enthusiasts, as well as easy access to urban opportunities within a half-day drive (i.e., Rochester, Buffalo, Syracuse, Albany, New York City, Boston, and Philadelphia).

• Benefits begin within 1 month of hire
• Generous PTO package available
• Competitive salaries
• Professional development stipends and malpractice insurance
• Medical, dental, and vision insurance
• Optional life and disability insurance
• 403(b) retirement plan with employer contribution
• Tuition assistance
• Career advancement opportunities
• Cell phone discount
• Major holidays off