RCM Specialist I - Insurance Verification/Prior Auth Specialist

Jordan Young Institute • Virginia Beach, VA

4d

About The Position

Aligned Orthopedic Partners is recruiting for an experienced RCM Specialist I to support billing operations across multiple locations. This role is crucial for ensuring accurate insurance verification and prior authorization processes, contributing to the overall efficiency of the billing operations.

Requirements

• High School Diploma
• Able to multi-task and capable of remaining calm in a stressful situation
• Able to use a multi-line telephone system and the billing computer program
• Excellent written, verbal, and interpersonal communication skills.
• Proficiency with Microsoft Excel and Word
• Accurate and efficient data entry skills
• Strong attention to detail
• Proficient computer software and database skills.
• Strong analytical skills.
• Demonstrates working knowledge of medical terminology, diagnostic and procedural coding and the medical billing process

Nice To Haves

• Familiarity with federal, state and commercial insurance guidelines and policies preferred

Responsibilities

• Accurately perform insurance verifications, pre-certification/pre-authorization functions as required/assigned in a timely manner.
• Ensure new patients added to the schedule are properly verified and authorized to be seen; updates patient accounts.
• Perform electronic insurance eligibility confirmation when applicable and document results.
• Assign insurance plans accurately.
• Contact patients and insurance plans to confirm or obtain missing information.
• Respond to patient and staff inquiries related to insurance questions.
• Communicate insurance changes or trends to staff and the RCM team.
• Check designated voicemail throughout the day to ensure prompt follow up.
• Perform designated functions required for accurate daily close of the billing system.
• Work collaboratively with peers to cover workloads, special projects, and other duties.
• Work with all other functional areas of the Revenue Cycle Management team, including EDI/claims, charge posting, payment posting and patient accounts.
• Communicate all issues or potential issues to leadership.
• Assist in preparation of practice summary reports, as requested or assigned.
• Attend regularly scheduled business office meetings; assist in identifying “best coding and billing practices” to ensure appropriate reimbursement.

Benefits

• medical and dental benefits
• employer-paid short-term and long-term disability coverage
• a matching 401K program
• generous paid time off
• continuous learning and development

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED