MRI Referral and Authorization Specialist

Healthcare Outcomes Performance Company•Wellington, FL

13h•Onsite

About The Position

Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise. Center for Bone & Joint Surgery of the Palm Beaches offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy. As Center for Bone & Joint Surgery continues to grow, we are seeking a Referral & Authorization Specialist- Full time (M-F) Onsite

Requirements

High school diploma/GED or equivalent working knowledge preferred.
Minimum one year of experience in a healthcare environment in a referral, front desk, or billing role.
Minimum one year of experience in medical insurance authorizations required

Nice To Haves

Minimum one year of Athena experience preferred
MRI authorization experience is a plus

Responsibilities

Verifies and updates patient registration information in the practice management system.
Obtains benefit verification and necessary authorizations (referrals, precertification) before patient arrival for all ambulatory visits, procedures, injections, and radiology services.
Uses online, web-based verification systems and reviews real-time eligibility responses to ensure 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.
Completes chart prepping tasks daily to ensure a smooth check-in process for the patient and clinic.
Researches all information needed to complete the registration process including obtaining information from providers, ancillary services staff, and patients.
Fax referral form to providers that do not require any records to be sent. Be able to process 75-80 referrals daily. For primary specialty office visits, fax referral/authorization form to PCPs and insurance companies in a timely fashion.
Reviews and notifies front office staff of outstanding patient balances.
Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
Respond to In-house provider and support staff questions, requests, and concerns regarding the status of patient referrals, care coordination, or follow-up status.
Identifies and communicates trends and/or potential issues to the management team.
Index referrals to patient account for existing patients.
Create new patient accounts for non-established patients to index referrals.