Authorizations Specialist

Orthopedic-Centers-of-Colorad; Colorado; On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Generous PTO

Life insurance

Disability insurance

Training & development

Retirement plan

Job summary

Orthopedic Centers of Colorado is seeking an Authorization Specialist to support Clinical, Imaging, and Physical Therapy departments. You will verify insurance, obtain authorizations for various procedures, and pre-collect for upcoming services while actively interacting with medical staff and patients.

Responsibilities include verifying eligibility, auditing authorizations, documenting in PM/EMR systems, and educating staff on authorization processes.

Qualifications

• Medical terminology, ICD-10 and CPT coding knowledge.
• Knowledge of contracted insurance plans and procedures.
• Solid computer and phone skills.
• Strong organizational and interpersonal skills.

Responsibilities

• Authorize scheduled procedures including surgeries, injections, imaging, and other items needing authorization.
• Verify eligibility and benefits for all patients and codes; pre-collect payments as required.
• Ensure compliance with benefits and funding requirements and document accuracy in EMR/PM systems.
• Educate staff on authorization obligations and manage authorization queue daily.
• Document authorizations in the EMR and update patient tracking as needed.
• Respond to urgent situations and follow clinic protocols.

Skills

Medical terminology

ICD-10 coding

CPT coding

Insurance knowledge

Organization

Interpersonal skills

Job description

The Authorization Specialist supports the Clinical, Imaging, and Physical Therapy departments. Daily tasks will include verification of a patient’s insurance information, obtaining authorizations for, but not limited to, procedures, surgeries, injections, imaging, office visits, and pre-collection for upcoming services to be rendered. This role will also actively interact with the medical staff and patients.

ESSENTIAL FUNCTIONS:

• Authorize scheduled procedures to include surgeries, injections, medications, physical and occupational therapy, imaging and other items needing authorization with insurance.
• Verify eligibility and benefits for all patients and procedure codes, pre-collect payment for surgeries and other procedures as required by the department
• Ensure compliance with benefits, authorizations, and/or funding requirements and limitations.
• Confirm that all information documented in the Practice Management System is accurate.
• Document work processes as required.
• Educate staff members on authorization obligations and accountability to internal processes in a timely manner.
• Manage authorization queue, workbook, or schedule by auditing daily changes and having clear documentation.
• Setup Patient tracking via tasking within the patient Electronic Medical Records System.
• Innovation of processes to facilitate the most efficient workflow.
• Document in Electronic Health Records System prior authorizations information obtained.
• Treatment authorized, date range approved for, authorization numbers and insurance company contact information.
• Must be able to recognize and respond appropriately to urgent situations.
• Follow all written protocols and procedures of the clinic including the OCC handbook, all department policy and procedures.
• Provide timely, high quality patient service and submission of authorizations, from all areas of responsibility by being courteous and helpful to all.
• Perform other duties assigned by OCC leadership.

Requirements

REQUIRED QUALIFICATIONS AND SKILLS:

• Medical terminology, ICD-10 and CPT coding knowledge
• Knowledge of contracted insurance plans and procedures
• Solid computer and phone skills
• Strong organizational and interpersonal skills
• Ability to prioritize responsibilities and multi-task efficiently and effectively
• Adaptability to different plan and lien requirements

PAY & BENEFITS:

• Medical, Dental and Vision Insurance
• Generous PTO package and paid holidays
• Company-paid life insurance and long term disability insurance
• Ability to purchase accident insurance, short and long-term disability insurance.
• Opportunities for internal training and development
• Retirement Plan eligibility after one month of service with eligibility in company profit sharing
• Most positions offer Monday – Friday work schedules

WORKING CONDITIONS:

• Typical business office environment
• Possibility of local travel
• Constant viewing of computer monitor, mousing and typing
• Frequent standing, walking, sitting, lifting, bending, handling up to 10 pounds
• Specific vision abilities required by this job include close vision, color vision, peripheral vision, and ability to adjust focus
• Hours of business are Monday – Friday from 7:00 a.m. to 6:00 p.m. Must be able to work early, late and long hours, as needed, to meet the essential functions of the job