EmergeOrtho
Authorizations Specialist
EmergeOrtho, Wilmington, North Carolina, United States, 28412
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.
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 preferredQualifications and Experience:
Prior medical assistant experienceStrong customer service skillsAbility to positively interact with providers, staff, patients and their family members.Ability to work in a fast-paced environmentAbility to prioritize and handle multiple tasks and demandsSound interpersonal skillsStrong organizational skillsStrong computer skillsObtain authorizations from various insurance companiesContact patients to schedule appointments for study/Injections and for resultsComplete MRI screening form with patientsDocument all appointments and times in EMR and AthenaScan and drop MRI/Visco related documentsSubmit to insurance for benefits and coverage detailsCollect any patient financial obligationsResponsibilities 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.
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.
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 preferredQualifications and Experience:
Prior medical assistant experienceStrong customer service skillsAbility to positively interact with providers, staff, patients and their family members.Ability to work in a fast-paced environmentAbility to prioritize and handle multiple tasks and demandsSound interpersonal skillsStrong organizational skillsStrong computer skillsObtain authorizations from various insurance companiesContact patients to schedule appointments for study/Injections and for resultsComplete MRI screening form with patientsDocument all appointments and times in EMR and AthenaScan and drop MRI/Visco related documentsSubmit to insurance for benefits and coverage detailsCollect any patient financial obligationsResponsibilities 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.