RCM Specialist I - Insurance Verification/Prior Auth Specialist

Aligned Orthopedic Partners • Virginia Beach, VA

4d

About The Position

Aligned Orthopedic Partners is a well-respected private orthopedic team comprised of highly trained, board-certified orthopedic surgeons devoted to delivering the highest orthopedic care possible. Our commitment to finding the best solutions for individual needs sets us apart from the competition. We take pride in providing exceptional care while remaining friendly, courteous, and efficient. Aligned Orthopedic Partners is recruiting for an experienced RCM Specialist I to support billing operations across multiple locations.

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
• 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
• an environment that celebrates continuous learning and development

What This Job Offers

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