Authorization Coordinator
About The Position
Are you passionate about serving patients in an inspiring work environment alongside talented people? Get moving with OCR! With over 50 years in business, we are the premier provider of orthopedic care in Colorado, Wyoming, and Nebraska. Our organization continues to grow and we are looking for individuals who share our mission. The Authorization/Benefits Coordinator primarily manages all aspects of the surgical benefits process including verifying patient benefits, contacting patients regarding eligibility and payment, entering surgical charges and receipts, following up on aging receivables, and resolving any issues related to this process. This position works closely with insurance coordinators to develop knowledge, communicate changes or adjustments and resolve issues with patient accounts. This position will have options for remote work and has the potential to work out of other OCR locations.
Requirements
- High school diploma or equivalent is required.
- Minimum 1 year experience in the insurance or medical industry or equivalent experience with collections in a business/accounting department.
- Knowledge of medical terminology preferred.
Responsibilities
- Determines patient out-of-pocket expenses using estimate provided by surgery authorization personnel and patient insurance plan.
- Notifies patients of determined expenses and establishes payment arrangements per guidelines and department protocols.
- Provides prompt support for check-in personnel regarding insurance eligibility issues (e.g. proper determination of type of account, correct billing information, insurance coverage) at the time the patient is present in the clinic. This may include answering questions over the phone, meeting with patients, or following up with insurance carriers.
- Maintains complete, accurate and up-to-date notes in patient account regarding surgical benefits and pre-authorizations and disseminates surgery authorization log appropriately.
- Responds to insurance companies’ requests for information in a prompt and professional manner.
- Corrects errors in assigned accounts and communicates other account errors to the respective Insurance Coordinator. Brings all errors to complete resolution.
- Identifies problem accounts on a timely basis and communicates them to supervisor for further action.
- Follows up on all denials, claim suspensions, and severe reductions in reimbursement promptly, exercising all options to obtain payment.
- Demonstrates consistent collection work by monitoring patient accounts for payment of surgical agreements.
- Follows up with patient and/or Insurance Coordinator regarding outstanding balance of payment issues.
- Routinely audits coding and demographical data on visit tickets to ensure the accuracy of claims.
- Acts as backup for surgery authorization personnel on an as needed basis.
- Communicates all concerns, risk management issues, breakdown in protocol and constructive criticisms to supervisor.
- Follow chain-of-command established by supervisor when addressing protocol issues outside of business office department.
- Other duties as assigned.
Benefits
- Medical, Dental, & Vision coverage
- Life and AD&D Insurance
- Short- and Long-term disability coverage
- Retirement savings and profit-sharing plan participation
- Employee Assistance Program
- Paid Holidays & Paid Time Off
- Company-sponsored events
- Annual merit increases
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
