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Medical Authorization Coordinator

2 months ago

Davenport, Iowa, United States Orthopaedic Specialists PC Full time
Position Overview

ROLE SUMMARY: The primary duty of the Medical Authorization Coordinator is to secure prior authorization for various medical services, including surgical procedures and durable medical equipment (DME). This role also involves communicating payment expectations to patients regarding their insurance coverage and co-insurance responsibilities.

EDUCATIONAL BACKGROUND:

  • Associate's Degree or relevant experience in medical billing, including applicable certifications.

EXPERIENCE AND SKILLS:

  • Preferred two to three years of experience in billing within a private practice environment.
  • Familiarity with the accounts receivable process is essential.
  • Demonstrated ability to manage multiple tasks effectively while maintaining composure under pressure.
  • Strong communication and organizational skills are critical, with a keen attention to detail.
  • Capable of working both independently and collaboratively within a team setting. Adaptability to various roles as required.
  • Proficient in establishing and nurturing positive relationships with patients, colleagues, and healthcare providers, even in high-stress situations.
  • Comfortable utilizing email and web-based applications.

Key Responsibilities:

Essential Duties:

  • Exhibit exceptional communication and organizational abilities. Capable of multitasking and collaborating effectively with team members while also working independently.
  • Maintain a friendly and professional demeanor when interacting with patients and insurance representatives.
  • Build and sustain effective working relationships with patients, coworkers, and other healthcare professionals, particularly under stressful circumstances.
  • Demonstrate meticulous attention to detail in all tasks.
  • Secure necessary authorizations for surgical procedures, diagnostic tests, physical therapy, and other services requiring pre-approval.
  • Possess superior verbal communication skills.
  • Facilitate the transmission of documents to relevant parties as required.
  • Inform patients about payment details prior to scheduled surgeries.
  • Exhibit proficiency in practice management and word processing software.
  • Maintain organized and accurate records.
  • Achieve accounts receivable targets through best practices and benchmarking.
  • Provide backup support for fundamental billing functions as needed, including:
    • Investigating claim discrepancies and expediting resolutions.
    • Handling requests for documentation related to claims processing.
    • Completing month-end financial tasks.

Additional Responsibilities:

  • Participate in annual training sessions and updates relevant to the role, including industry standards and compliance regulations.
  • Ensure patient confidentiality and adhere to HIPAA guidelines and practice compliance protocols.
  • Maintain a thorough understanding of practice management software and its application to job functions.
  • Engage in continuing education opportunities as necessary.
  • Attend all required meetings and training sessions.
  • Perform any other duties as assigned by the Supervisor/Manager.
  • Uphold high ethical standards and hold oneself and others accountable for professional conduct.

Supervisory Role:

This position does not involve supervisory responsibilities.

Physical Requirements:

The role necessitates prolonged periods of sitting, with some bending and stretching. Good hand-eye coordination and manual dexterity are required to operate office equipment such as keyboards, photocopiers, and telephones. The employee must possess normal hearing and vision to prepare and communicate reports effectively.

Work Environment:

This position is situated in a standard office setting.