The CORE Institute
Prior Authorization Specialist
The CORE Institute, Jacksonville, Florida, United States, 32290
At
Southeast Orthopedic Specialists , we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:Competitive Health & Welfare BenefitsMonthly $43 stipend to use toward ancillary benefitsHSA with qualifying HDHP plans with company match401k planEmployee Assistance Program that is available 24/7 to provide supportEmployee Appreciation DaysEmployee Wellness EventsAs Southeast Orthopedic Specialists continues to grow, we are hiring
Prior Authorization Coordinator
for our
Southside Clinic!Please see below for the functions and requirements for this position:GENERAL STATEMENT OF DUTIESThe DME Prior Authorization Specialist is responsible for completing the pre-registration, registration, eligibility verification, verification of benefits and pre-certification/documentation processes which involves communicating with patients, and insurance companies to ensure that all appropriate demographic and reimbursement information is accurate to prior to the patient’s scheduled appointment.QUALIFICATIONS
High school diploma/GED or equivalent working knowledge preferred.Minimum two to three years of experience in a healthcare environment in a prior authorization capacity. DME prior authorization experience highly preferred.Must be able to communicate effectively with physicians, patients and the public and be capable of establishing good working relationships with both internal and external customers.Must have Healthcare experience with Managed Care Insurance, requesting authorizations for Insurance, and verifying insurance benefits.In-depth knowledge of insurance plan requirements for Medicaid and commercial plans.ESSENTIAL FUNCTIONSObtains benefit verification and necessary authorizationsUses online, web-based verification systems and reviews real-time eligibility responses to ensure the accuracy of insurance eligibility.Creates appropriate referrals to attach to pending visits.Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.Respond to In-house provider and support staff questions, requests, and concerns regarding the status of patient prior authorizations.EDUCATIONHigh school diploma/GEDKNOWLEDGEKnowledge of government provisions and billing guidelines including Coordination of Benefits.Advanced computer knowledge, including Windows-based programs.Knowledge of eligibility verification and prior authorizations for payment from various HMOs, PPOs, commercialpayers, and other funding sources.ABILITIESAbility to multi-task in a fast-paced environment. Must be detail-oriented with strong organizational skills.Ability to understand patient demographic information and determine insurance eligibility.Ability to type a minimum of 45 wpm.ENVIRONMENTAL WORKING CONDITIONSNormal office environmentPHYSICAL/MENTAL DEMANDSRequires sitting and standing associated with a normal office environment.Some bending and stretching are required.Manual dexterity using a calculator and computer keyboard.
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Southeast Orthopedic Specialists , we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:Competitive Health & Welfare BenefitsMonthly $43 stipend to use toward ancillary benefitsHSA with qualifying HDHP plans with company match401k planEmployee Assistance Program that is available 24/7 to provide supportEmployee Appreciation DaysEmployee Wellness EventsAs Southeast Orthopedic Specialists continues to grow, we are hiring
Prior Authorization Coordinator
for our
Southside Clinic!Please see below for the functions and requirements for this position:GENERAL STATEMENT OF DUTIESThe DME Prior Authorization Specialist is responsible for completing the pre-registration, registration, eligibility verification, verification of benefits and pre-certification/documentation processes which involves communicating with patients, and insurance companies to ensure that all appropriate demographic and reimbursement information is accurate to prior to the patient’s scheduled appointment.QUALIFICATIONS
High school diploma/GED or equivalent working knowledge preferred.Minimum two to three years of experience in a healthcare environment in a prior authorization capacity. DME prior authorization experience highly preferred.Must be able to communicate effectively with physicians, patients and the public and be capable of establishing good working relationships with both internal and external customers.Must have Healthcare experience with Managed Care Insurance, requesting authorizations for Insurance, and verifying insurance benefits.In-depth knowledge of insurance plan requirements for Medicaid and commercial plans.ESSENTIAL FUNCTIONSObtains benefit verification and necessary authorizationsUses online, web-based verification systems and reviews real-time eligibility responses to ensure the accuracy of insurance eligibility.Creates appropriate referrals to attach to pending visits.Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.Respond to In-house provider and support staff questions, requests, and concerns regarding the status of patient prior authorizations.EDUCATIONHigh school diploma/GEDKNOWLEDGEKnowledge of government provisions and billing guidelines including Coordination of Benefits.Advanced computer knowledge, including Windows-based programs.Knowledge of eligibility verification and prior authorizations for payment from various HMOs, PPOs, commercialpayers, and other funding sources.ABILITIESAbility to multi-task in a fast-paced environment. Must be detail-oriented with strong organizational skills.Ability to understand patient demographic information and determine insurance eligibility.Ability to type a minimum of 45 wpm.ENVIRONMENTAL WORKING CONDITIONSNormal office environmentPHYSICAL/MENTAL DEMANDSRequires sitting and standing associated with a normal office environment.Some bending and stretching are required.Manual dexterity using a calculator and computer keyboard.
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