Authorization and Eligibility Specialist

2 weeks ago


Peoria, Arizona, United States OrthoArizona Full time
About OrthoArizona

At OrthoArizona, we strive to deliver exceptional patient care and innovative solutions in the field of orthopedics and podiatry. Our organization is dedicated to bringing together the best professionals to serve the needs of our community.

Job Summary

We are seeking a highly skilled Authorization and Eligibility Representative to join our team. As a key member of our staff, you will be responsible for verifying insurance coverage, navigating insurance portals, and reconciling obtained information to ensure successful claim processing.

Key Responsibilities
  • Verify insurance coverage for potential new patients, add-ons, and re-verify insurance coverage for existing patients.
  • Navigate through multiple insurance portals or by phone to obtain necessary insurance benefits.
  • Reconcile obtained information within the Practice Management System, EMR, and Phreesia to ensure successful claim processing.
  • Responsible for obtaining all referrals and authorizations for Physical Therapy Patients, as required.
  • Act as a liaison between patients, healthcare providers, and insurance carriers to ensure all proper measures are taken and information is collected.
  • Enter any authorization numbers and expiration dates into the Practice Management System, EMR, and Phreesia for proper claim processing.
  • Update pertinent insurance notes in multiple EMR systems for corresponding departments to access.
  • Maintain medical records in accordance with practice policies and procedures.
Requirements
  • Excellent customer/patient service.
  • Knowledge of medical terminology.
  • Working knowledge of computer programs.
  • Excellent written and verbal communication skills.
  • Understand/perform training on practice management software.
  • Ability to promote a favorable facility image with physicians, patients, insurance companies, and the general public.
  • Ability to communicate effectively on the telephone.
  • Ability to make decisions and solve problems.
  • Working knowledge of health insurance plans, including reading plan requirements.
  • Follow all Standard Operating Procedures.
  • High School diploma or GED.
  • Minimum of 2 years of experience in healthcare administration or a related field.
  • Strong organizational and communication skills.
  • Ability to work independently and as part of a team.
  • Ability to meet metric deadlines and stay within goal expectations with little oversight.
  • Knowledge of medical terminology and insurance authorization processes.
Preferred Qualifications
  • Centricity Software and Phreesia Experience.
Benefits
  • Robust paid time off package, including sick time, holidays, and paid time off.
  • Medical insurance, including a plan with 100% employer coverage (a $585 monthly value).
  • Health Savings account + company contributions.
  • Dental and Vision insurance.
  • Company-paid life insurance policy + the option to purchase additional benefits to protect you from what life throws at you.
  • 401(k) with a company contribution + profit sharing.
  • Pet insurance.
  • ID Theft protection and Legal assistance.

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