Reimbursement Assistant - Joint and Limb Preservation
About The Position
This position assists the Joint and Limb Preservation teams with insurance authorization processes for orthopaedic surgical procedures and outpatient psychology appointments. The Reimbursement Assistant serves as the primary point of contact for patients regarding surgical authorizations, insurance coverage, and billing. They maintain timely communication with patients and care teams about authorization status, peer-to-peer reviews, denials, and appeals. The role involves coordinating peer-to-peer reviews, assisting with appeals, and monitoring/documenting authorization and denial activity. Additionally, the position audits billing and denial information, collaborates with teams to resolve post-service denials, and identifies recurring barriers to communicate for process improvement. The role also supports patient scheduling, paperwork, inquiries, operating room scheduling, and other clinical/administrative needs. It provides backup administrative coverage for classes and front-desk operations, participates in team meetings to communicate barriers, and facilitates communication among patients, clinical staff, and administrative teams. Research support includes data entry, completing human-subjects research training, serving as backup research team member for consent and study visits, assisting with scheduling research activities, and conducting patient outreach for research and follow-up. The ideal candidate possesses a growth mindset, strong communication and organizational skills, persistence, a solution-oriented approach, and a willingness to learn. Experience with healthcare revenue cycle, insurance authorization, or clinical operations is preferred but not required. The Joint and Limb Preservation programs are highly integrated and collaborative, offering opportunities to contribute to patient care and program improvement. This position is a key resource for revenue-cycle and insurance-related processes, helping patients navigate authorization requirements and proactively resolving barriers to care. The successful candidate will be comfortable taking ownership, communicating across disciplines, and learning new processes.
Requirements
- An associate degree in medical coding, medical office technology or other medical related area, or an equivalent combination of education and experience from which comparable knowledge and abilities can be acquired is necessary.
Nice To Haves
- Experience with healthcare revenue cycle, insurance authorization, or clinical operations is preferred but not required.
- Two years of medical related experience with knowledge of medical terminology, one of which in medical coding experience, is preferred.
Responsibilities
- Assist the Joint and Limb Preservation teams with insurance authorization processes for orthopaedic surgical procedures and outpatient psychology appointments, including submission, tracking, and follow-up as appropriate.
- Serve as the primary point of contact for patients with questions regarding surgical authorizations, insurance coverage, and billing, coordinating with appropriate departments when additional assistance is needed.
- Maintain timely communication with patients and members of the care team regarding the status of authorizations, peer-to-peer reviews, denials, and appeals to minimize delays in patient care.
- Coordinate peer-to-peer reviews following insurance denials and assist with drafting and submitting patient appeal letters and supporting documentation.
- Monitor and document authorization and denial activity in applicable systems to ensure accurate and timely follow-up.
- Audit billing and denial information and collaborate with Revenue Cycle and clinical teams to investigate and resolve post-service denials and other insurance-related barriers.
- Identify recurring authorization, coverage, or billing barriers and communicate trends to the Joint and Limb Preservation teams to support process improvement.
- Support the Joint and Limb Preservation teams with patient scheduling, paperwork, patient inquiries, operating room scheduling, and other clinical and administrative needs.
- Provide backup administrative coverage for MU Joint Health Program classes and front-desk operations as needed.
- Participate actively in Joint and Limb Preservation team meetings, communicating patient access, authorization, scheduling, and other barriers that may affect timely care.
- Facilitate communication among patients, clinical staff, and administrative teams to help coordinate care and resolve barriers throughout the patient's care pathway.
- Assist with accurate and timely data entry used to track patients, clinical activities, and outcomes within the center.
- Complete required human-subjects research and IRB-related training and serve as a backup research team member for patient consent and/or research visit activities, as permitted by study protocols.
- Assist with scheduling research-only visits, imaging, and other study-related activities.
- Conduct patient outreach and reminders related to research participation, clinical follow-up, and completion of patient-reported outcome measures.
- Collaborate with clinical and research team members to support integration of research activities into routine clinical workflows.
Benefits
- Health, vision and dental insurance coverage starting day one
- Generous paid leave and paid time off, including nine holidays
- Multiple retirement options, including 100% matching up to 8% and full vesting in three years
- Tuition assistance for employees (75%) and immediate family members (50%)
- Discounts on cell phone plans, rental cars, gyms, hotels and more
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
