Authorization Specialist

1 month ago


San Antonio, United States TSAOG Orthopaedics & Spine Full time
Job Details

Level
Experienced

Job Location
Annex - San Antonio, TX

Position Type
Full Time

Education Level
High School

Salary Range
$16.00 - $23.36 Hourly

Travel Percentage
None

Job Shift
Day

Job Category
Health Care

Description

Get to know us:

TSAOG Orthopaedics and Spine is a large multi-specialty physician group. We have been here since 1947 and were not going anywhere. We take a big part in Community outreach with our Light Charity program. If you are looking for a team that enjoys Laughing, is Family orientated, and has the work hard play hard mentality, then this company is for you. We value Respect, Communication, Accountability, Dependability and Compassion. A place where you can rely on great Teamwork and Integrity. We are a place that is true to its values. If this is what you are looking for then look no further.

Summary of position:

We are looking for a sharp, ambitious, and enthusiastic Authorization Specialist to join our team. The successful candidate is someone that is passionate about working in a care team model with a personal responsibility of providing care for our orthopaedics patients and clinical support to the team. The right candidate will be able to provide an exceptional patient care experience that promotes healing and recovery, and having an attention to detail mindset while being caring and compassionate.

If you're a people person looking to join an amazing company in the world of Orthopaedics, this is the place for you

JOB SUMMARY: Gathers pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient is not financially obligated for services provided.

DUTIES INCLUDE, BUT ARE NOT LIMITED TO:
  • Resolves pre-certification, registration and case-related concerns prior to a patient's appointment.
  • Ensures patients have been cleared for specialty service office visits.
  • Obtains referrals from primary care physicians.
  • Verify eligibility and benefits to establish office visit.
  • Work on daily list for designated physician(s) and follow up with office via fax to determine patient coverage, coordination of benefits, etc.
  • Do precertification for surgical procedures (call insurance company to verify if deductible met, fax clinical to insurance company precertification department to obtain authorization for procedure).
  • Respond to phone calls from internal doctor teams, check in/check out staff, or primary care physician offices and respond accordingly.
  • Relays pertinent messages from hospitals and directs team to reschedule surgical procedures at facility where benefits are accepted.
  • Assist billing department to obtain retro referrals for services that were rendered (either office visits or surgical procedures). This may include hospital procedures, office visits or outpatient surgical procedures.
  • Review daily schedules to verify that visits have been through pre-authorization process. Any new additions to the schedule will require coordination of benefits and follow up with the respective department.
  • Review personal faxes for newly scheduled surgery and conduct insurance verification and obtain proper authorizations.
  • Daily review of internal practice management system for requests from doctors team offices. This may include rescheduled surgeries, rescheduled office visits, etc.
  • May explain benefits information to patients who arrive to visit and may not understand their portion of the bill (co-pay, deductibles, etc.).
  • Data enter pre-authorization deductibles, co-insurance, out-of-pocket and related information in to patient demographic record.
  • Regular and predictable attendance
What you'll need:
  • Must have a High School Diploma or equivalent.
  • Knowledge of health insurance concepts (i.e., HMO, PPO, etc.). Experience in a healthcare environment a plus.
  • Proficient computer skills. Exceptional customer service skills. Proficient and accurate data entry skills..
  • Ability to multi-task, prioritize work and make sound judgments. Ability to remain patient during long periods of telephonic hold times..
  • Other duties as assigned as necessary and may vary at times, as needed, by your immediate supervisor or as directed by the company.
  • Prolonged sitting. Repetitive motion (data entry), and phone contact.

#BackOffice4

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