Therapy Authorizations Specialist

4 weeks ago

Redlands, California, United States Arrowhead Orthopaedics Full time
Job Title: Therapy Authorizations Processor

Arrowhead Orthopaedics is seeking a highly skilled Therapy Authorizations Processor to join our team. As a key member of our Authorization Department, you will play a critical role in ensuring the smooth operation of our orthopaedic care services.

Job Summary:

The Therapy Authorizations Processor will be responsible for verifying patient benefits, requesting pre-certification for surgeries and DME items, and submitting authorizations for follow-up visits. You will also be responsible for scheduling appointments at outside facilities, covering HMO Surgery authorization coordinator duties, and answering patient calls.

Responsibilities:
  • Verify patient benefits for PPO/Medicare/Private patients
  • Request pre-certification for surgeries and DME items
  • Submit authorizations for follow-up visits
  • Schedule appointments at outside facilities
  • Cover HMO Surgery authorization coordinator duties
  • Answer patient calls
  • Verify EMG/ESI/orthovisc benefits for PPO/Medicare/Private patients
  • Keep surgery follow-up log updated
  • Confirm outpatient surgeries able to go to AASC
  • Handle calls from insurance companies regarding surgery dates
  • Submit for all DMEs, diagnostic studies, visco supplement injections & Doctor-to-Doctor referrals
  • Call daily to follow up on submitted surgeries for authorization status
  • Extend surgery authorizations for surgeries whose authorization has expired
  • Coordinate peer-to-peer calls for physicians
  • Coordinate delivery of visco supplemental injections with third-party vendors
  • Coordinate delivery of DME with multiple vendors
  • Coordinate scheduling of diagnostic studies with multiple third-party vendors
  • Coordinate scheduling of Doctor-to-Doctor referrals
  • Call interpreter to inform of patient appointments
  • Check on faxes and keep correspondence current
Requirements:
  • High school diploma or equivalence
  • Ability to type 40 words per minute
  • Skilled in operating a computer and scanner, as well as software programs including Microsoft Outlook
  • Superior customer service and professional communication skills
  • Flexibility and ability to multitask in a stressful setting
Working Conditions:

The Therapy Authorizations Processor will work primarily in the Authorization Department located in Arrowhead Orthopaedics' offices. The employee will come into contact with confidential patient files and must be able to handle this information with the highest degree of privacy, discretion, and professionalism.

Salary:

$18-21/hour

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