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Total Orthopedics and Sports Medicine is a multi-office provider of musculoskeletal care. We are searching for a Full time authorization specialist for our Bayonne office. This individual should be friendly and out going and shares the same drive we do for patient satisfaction. Candidates should have a background in authorizations and healthcare a plus. Additionally, candidate should have knowledge of Pip and Comp Authorizations.
Job Duties And Responsibilities:
- Will pre-certify all patient testing, procedures and injections by confirming their insurance/managed care plan eligibility in addition to confirming whether prior authorization for visits and treatments are necessary. ·
- Advises both physician and patient of insurance findings and benefit investigations. Will assist patients with the proper forms necessary for CDF and GATCF and confirm when funding is in place. Provides the proper clinical documentation to the foundations as needed. ·
- Obtains and/or advises patients of the need for referrals as indicated on their insurance plan. Obtains all Healthcare Partners referrals for existing patients providing all clinical documents, as necessary. ·
- Advises staff of any insurance plan updates. ·
- Checks patient balances on upcoming appointments for accuracy and presents to the front desk to collect.
- Monitoring immediate care schedule as they come in to check eligibility.
- Coordinate with call center and front-end managers regarding scheduling errors
- Works in conjunction with call center to ensure clean billing.
- Knowledge of in/out-of-network insurances.
- Verifying health insurance benefits for all new patients or existing patients.
- Verifies coverage levels and works with patients to walk them through their benefit information.
- Helps to arrange alternative payment methods.
- Performs other related duties as assigned by senior management.
Job Type: Full-time
Benefits:
- 401(k) matching
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: One location
