Orthopaedic Preauthorization Specialist

4 weeks ago


Fort Walton Beach, Florida, United States Orthopaedic Associates (Fort Walton Beach) Full time
Job Overview

We are seeking a highly skilled and detail-oriented individual to join our team as an Orthopaedic Preauthorization Specialist at Orthopaedic Associates (Fort Walton Beach). In this role, you will play a critical part in ensuring the efficient operation of our Preauthorization Department.

Responsibilities:

  • Review and evaluate preauthorization requests for orthopaedic procedures and treatments, ensuring completeness and accuracy of documentation.
  • Verify patient insurance coverage and eligibility for requested services.
  • Collaborate with healthcare providers to gather necessary medical records and supporting documentation.
  • Communicate with insurance companies to obtain preauthorization approvals or address any additional information or documentation requirements.
  • Maintain accurate and up-to-date records of preauthorization requests, approvals, and denials.
  • Educate healthcare providers on preauthorization requirements and assist in resolving any preauthorization-related issues or concerns.
  • Stay updated on insurance industry regulations, policies, and guidelines related to orthopaedic preauthorization.

Requirements:

  • Prior experience in orthopaedic preauthorization or medical insurance verification preferred.
  • Strong knowledge of orthopaedic procedures, treatments, and medical terminology.
  • Familiarity with insurance coding systems (e.g., CPT, ICD-10) and insurance claim processes.
  • Excellent attention to detail and ability to analyze complex medical documentation.
  • Strong communication skills, both written and verbal, with the ability to effectively interact with healthcare professionals, insurance companies, and patients.
  • Proficient computer skills, including experience with electronic medical record (EMR) systems and preauthorization software.
  • Ability to work independently and as part of a team, managing multiple priorities and meeting deadlines in a fast-paced environment.
  • Commitment to maintaining patient confidentiality and adhering to HIPAA guidelines.

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