Surgery Authorizations - Orthopedic/Spine

Orthopedic Specialists of SW Florida•Fort Myers, FL

About The Position

Job Summary: Oversee all patient authorizations and related verification of insurance, procedure eligibility/coverage and patient benefit plan information. This position has unrestricted access to protected health information (PHI) pertaining to all patients. Essential Functions : Obtain insurance verification and authorization from insurance companies via telephone call, facsimile or online program Document benefit coverage and patient’s out-of-pocket expenses on authorization/verification form Scan authorization and verification of patient eligibility, benefits and out-of-pocket expenses Communicate with patients regarding their out-of-pocket expenses and arrange payment plans when necessary Communicate with medical assistants regarding patient eligibility and scheduling of procedures Schedule appointments for procedures once eligibility has been determined and proper authorization has been obtained Document all necessary patient information and notes in computer system Core Competences : Responsible for promoting the Standards of Excellence for Orthopedic Specialists while demonstrating courteous and cooperative behavior toward patients, visitors, volunteers, peers and physicians Maintain a neat and orderly work environment, demonstrates the ability to organize and prioritize work during heavy workload situations to expedite patient care Maintain strictest confidentiality in accordance with HIPAA compliance Perform quality work within deadlines with or without direct supervision Work effectively as a team contributor on all assignments Work independently while understanding the need to communicate and coordinate work efforts with other employees and organizations Minimum Requirements (education, experience, special skills and licenses or certifications required): High School diploma or GED required. Associates degree preferred Minimum of 2 years insurance and benefit experience Ability to perform essential duties Knowledge of medical insurance and billing Ability to identify and resolve collection issues Minimum Requirements (education, experience, special skills and licenses or certifications required) continued: Ability to document accounts clearly Computer Literate – Windows environment Knowledge of medical terminology Strong organizational skills Ability to perform basic mathematics Ability to clearly communicate written and verbal instructions Ability to efficiently manage multiple tasks and prioritize Ability to demonstrate proper telephone etiquette and computer skills Essential Physical Functions: Sitting long periods of time Manual dexterity sufficient to operate keyboard, calculator and other office equipment as necessary Ability to view computer screens for long periods of time Equipment Used: Computer, scanner, printer, calculator, photocopier, facsimile, telephones Additional Comments: Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. The above statements are intended to describe the general nature and level of work being performed by people assigned to this position. They are not intended to be an exhaustive list of responsibilities, duties and skills required of persons so assigned

Requirements

High School diploma or GED required.
Minimum of 2 years insurance and benefit experience
Ability to perform essential duties
Knowledge of medical insurance and billing
Ability to identify and resolve collection issues
Ability to document accounts clearly
Computer Literate – Windows environment
Knowledge of medical terminology
Strong organizational skills
Ability to perform basic mathematics
Ability to clearly communicate written and verbal instructions
Ability to efficiently manage multiple tasks and prioritize
Ability to demonstrate proper telephone etiquette and computer skills
Sitting long periods of time
Manual dexterity sufficient to operate keyboard, calculator and other office equipment as necessary
Ability to view computer screens for long periods of time

Nice To Haves

Associates degree preferred

Responsibilities

Obtain insurance verification and authorization from insurance companies via telephone call, facsimile or online program
Document benefit coverage and patient’s out-of-pocket expenses on authorization/verification form
Scan authorization and verification of patient eligibility, benefits and out-of-pocket expenses
Communicate with patients regarding their out-of-pocket expenses and arrange payment plans when necessary
Communicate with medical assistants regarding patient eligibility and scheduling of procedures
Schedule appointments for procedures once eligibility has been determined and proper authorization has been obtained
Document all necessary patient information and notes in computer system
Responsible for promoting the Standards of Excellence for Orthopedic Specialists while demonstrating courteous and cooperative behavior toward patients, visitors, volunteers, peers and physicians
Maintain a neat and orderly work environment, demonstrates the ability to organize and prioritize work during heavy workload situations to expedite patient care
Maintain strictest confidentiality in accordance with HIPAA compliance
Perform quality work within deadlines with or without direct supervision
Work effectively as a team contributor on all assignments
Work independently while understanding the need to communicate and coordinate work efforts with other employees and organizations