Authorization and Eligibility Representative

OrthoArizona; Gilbert (AZ); Presencial; USD 25.000 - 36.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Paid time off

Medical with plan options

Health Savings Account with company 1

Descripción de la vacante

OrthoArizona is seeking an Authorization & Eligibility Representative in Gilbert, AZ to verify insurance coverage for new and existing patients and to obtain referrals and authorizations as needed.

Join a large, privately owned orthopedic practice with multiple locations and a strong commitment to patient care. We value accuracy, teamwork, and proactive communication with patients and providers.

Formación

• 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 favorable facility image with physicians, patients, insurance companies, and 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 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.

Responsabilidades

• Verify insurance coverage for potential new patients and re-verify existing coverage.
• Navigate through insurance portals or by phone to obtain necessary benefits.
• Reconcile information within the Practice Management System, EMR, and Phreesia for claim processing.
• Obtain referrals and authorizations for Physical Therapy patients.
• Act as liaison between patients, providers, and insurance carriers.
• Enter authorization numbers and dates into the PM system, EMR, and Phreesia.
• Update insurance notes in EMR systems for departments to access.
• Maintain medical records per practice policies.
• Using state or federally regulated websites may require personal login credentials.

Conocimientos

Medical terminology

Computer skills

Verbal communication

Phone communication

Decision making

Health insurance knowledge

SOP adherence

Healthcare admin exp

Teamwork

Time management

Organizational skills

Educación

High School diploma or GED

Herramientas

Centricity Software

Phreesia

Descripción del empleo

Anticipate patient needs, exceed expectations, and create lifelong memories.

An orthopedic practice that is made up of over 70 premier specialists, specializing in sports medicine, joint replacement, arthroscopy, fractures, arthritis, and general orthopedic conditions in adult and pediatric patients. OrthoArizona offers a wide variety of services that include advanced imaging, physical therapy, diagnostic testing, casting, durable medical equipment, and workers’ compensation.

We are looking for employees who want to work for a fast-growing organization with a strong reputation for providing comprehensive, high-quality musculoskeletal care. We need professionals who share our vision and the commitment to see it through.

General Employee Benefits

We are committed to providing the best benefits options to our employees so we can support their health, wellness, and happiness.

Position: Authorization and Eligibility Representative

Location: Gilbert (South), AZ

Job Id:4132

# of Openings:1

Authorization & Eligibility Representative

About OrthoArizona:

At OrthoArizona, we are bringing the best together. Our organization was created to help serve ALL orthopedic and podiatry needs throughout the Valley! We have a wide range of orthopedic surgeons and mid-level providers including physical and occupational therapists.

Today we are one of Arizona’s largest privately owned and most comprehensive orthopedic practices with more than 75 locally and nationally renowned providers across 30 locations, in addition to 2 ambulatory surgical centers and in house state of the art MRI capabilities. At OrthoArizona we are committed to best-in-class patient care, being a pioneer in research and technology, and most importantly, rewarding and recognizing our employees.

As an Authorization & Eligibility Representative with OrthoArizona, you will get to:

• 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.
• Reconciles 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.
• Responsible for acting 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.
• **Using state or federally regulated websites may require personal login credentials.

Minimum Qualifications:

• 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 favorable facility image with physicians, patients, insurance companies, and 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 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

Full Time Benefits:

• Robust paid time off package including, sick time, holidays, & paid time off!
• Medical with multiple different plan options.
• Health Savings account + company contributions.