Orthopaedic Solutions Management Patient Access Representative II

1 month ago


Gainesville, Florida, United States Orthopaedic Solutions Management Full time
Job Summary

We are seeking a highly organized and detail-oriented Patient Access Representative II to join our team at Orthopaedic Solutions Management. In this role, you will be responsible for registering new patients, scheduling appointments, and verifying benefits through electronic eligibility systems.

Key Responsibilities:

  • Register all new patients in the computer system by obtaining patient demographics and insurance information.
  • Schedule appointments according to patient need and physician and authorization protocols.
  • Verify benefits through electronic eligibility systems to confirm effective date of insurance coverage, PCP information, and co-pay or co-insurance information.
  • Document all obtainable benefit information at time of scheduling to ensure easy passage to the Financial Clearance Team.
  • Update all information from prior visits as needed.

Authorization Responsibilities:

  • Coordinate with primary care physicians and/or insurance companies to obtain referrals for office visits prior to the scheduled appointment.
  • Ensure all authorizations are properly documented in the system.
  • Advise patients of any potential problems concerning obtaining authorization prior to the scheduled appointment.
  • Coordinate with the Billing/Collections department to research and obtain authorizations on previously denied claims.
  • Coordinate with the Benefit Verification Rep to confirm benefits when problems occur.
  • Utilize insurance websites to obtain referrals/authorizations.

Compliance and Other Duties:

  • Assure compliance with all company plans, policies, and procedures set forth by Orthopaedic Solutions Management.
  • Perform all other duties as assigned.

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