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Orthopaedic Preauthorization Coordinator
2 months ago
We are in search of a dedicated and detail-oriented professional to become a vital part of our healthcare organization as an Orthopaedic/Spine Preauthorization Specialist. In this role, you will be instrumental in facilitating the effective functioning of our Preauthorization Department. Your primary responsibility will be to assess and process preauthorization requests for a variety of services including Orthopaedic, Imaging, Surgery, Pain Management, and Spine treatments, while collaborating closely with healthcare professionals, insurance providers, and patients to secure timely approvals.
Key Responsibilities:- Assess and process preauthorization requests for orthopaedic services, ensuring all documentation is complete and accurate.
- Confirm patient insurance coverage and eligibility for the requested medical services.
- Work alongside healthcare providers to collect necessary medical records and supporting documents.
- Engage with insurance companies to secure preauthorization approvals and address any additional information requests.
- Maintain precise and current records of all preauthorization requests, including approvals and denials.
- Provide education to healthcare providers regarding preauthorization requirements and assist in resolving any related issues.
- Stay informed about industry regulations, policies, and guidelines pertaining to orthopaedic preauthorization.
- Experience in orthopaedic preauthorization or medical insurance verification is preferred.
- Strong understanding of orthopaedic procedures, treatments, and relevant medical terminology.
- Familiarity with insurance coding systems (e.g., CPT, ICD-10) and the insurance claims process.
- Exceptional attention to detail with the ability to analyze complex medical documentation.
- Strong written and verbal communication skills, enabling effective interaction with healthcare professionals, insurance representatives, and patients.
- Proficient in computer skills, including experience with electronic medical record (EMR) systems and preauthorization software.
- Ability to work independently as well as collaboratively, managing multiple priorities and meeting deadlines in a fast-paced environment.
- Commitment to upholding patient confidentiality and adhering to HIPAA regulations.
