Authorizations Specialist - Wilmington, United States - EmergeOrtho

Description

Description

EmergeOrtho is committed to being the trusted leader in innovative, quality-focused comprehensive musculoskeletal care. With offices across North Carolina,the Authorizations Specialist is responsible for procuring effective surgical authorization information for patient surgical services from appropriate insurance carriers.

*Once Training is completed, this position may have the opportunity to work from home.

Requirements

Educational Requirements:

• High school diploma or equivalent is required;
• A minimum of 3 to 5 years of experience in a medical office environment is preferred

Qualifications and Experience:

• Prior medical assistant experience
• Strong customer service skills
• Ability to positively interact with providers, staff, patients and their family members.
• Ability to work in a fast-paced environment
• Ability to prioritize and handle multiple tasks and demands
• Sound interpersonal skills
• Strong organizational skills
• Strong computer skills
• Obtain authorizations from various insurance companies
• Contact patients to schedule appointments for study/Injections and for results
• Complete MRI screening form with patients
• Document all appointments and times in EMR and Athena
• Scan and drop MRI/Visco related documents
• Submit to insurance for benefits and coverage details
• Collect any patient financial obligations

Responsibilities include, but are not limited to:

• Make calls to insurance companies for necessary surgical authorization of services for patient appointments.
• Utilize online services from insurance companies to obtain surgical authorizations and/or gather information regarding patients' coverage for services.
• Process all items for review in the practice management system and assigned to the department and/or third party software.
• Handle all calls and/or written inquiries regarding appointment service surgical authorizations through resolution.
• Research, correct and re-file any denied or rejected surgical authorization to maximize reimbursement.
• Ensuring surgical authorizations are up to date, entering surgical authorizations into EHR, scanning and linking surgical authorizations to the patient's chart.
• Extensive scheduling coordination with the surgery department, specialist and ancillary departments is needed.
• Contact patient insurance provider to obtain authorization and confirm eligibility status for the surgery and verify patient's insurance coverage to include deductibles, out of pocket maximums, etc.
• Using information obtained from insurance provider, calculates patient's payment amount to be paid to EmergeOrtho prior to surgery.
• Document all information obtained in the practice management system to adequately relay said information to all staff and/or third party software.
• Report rules, changes and other information affecting surgical authorizations to the Medical Records Supervisor.
• Print reports from the practice management system to facilitate surgical authorization for appointment services for previously scheduled patients and patients added on.
• Participate in educational and training opportunities to maintain current knowledge of payment policies Organize electronic patient records based on referral status.
• Fills in for other account representative positions as needed.
• Performs other duties as required and assigned by the Medical Records Supervisor.