Benefits & Prior Authorization Specialist — Orthotics

OTTO BOCK PATIENT CARE LLC; Pennsylvania; On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical

Vision

Dental

Health savings accounts with employer/

Flexible spending account options

Company-paid life insurance policy

Paid time off

Company holidays

Floating holidays

100% company-paid short & long-term

401k match up to 3.5%

DailyPay by ADP

Job summary

Ability Prosthetics & Orthotics is seeking a Verification of Benefits & Prior Authorization Coordinator to support clinics across Pennsylvania and Maryland. The role ensures accurate and timely prior authorizations and benefits verifications to facilitate patient care and billing processes.

The candidate should have strong communication skills, HIPAA awareness, and at least 2 years in medical billing, preferably in orthotics or prosthetics.

Qualifications

• Ability to work independently.
• Ability to prioritize and manage multiple tasks to completion.
• Outstanding verbal and written communications skills.
• Exceptional organizational skills.
• Minimum typing of 45 wpm; Excellent ten-key skills.
• Professional telephone manner: Ability to hear, communicate and comprehend by telephone for prolonged periods.
• Advanced problem-solving skills and demonstrated ability to use good judgment in resolving customer service issues.
• Ensures assigned work is complete and accurate by the end of work shift daily, weekly, and monthly.
• Strong computer skills; Proficient in MS Office and databases.
• Minimum 2 years' experience in medical billing, preferably with orthotics, prosthetics, and/or durable medical equipment industry.
• Experience with HIPAA regulations and Medicare and insurance carrier websites.
• Experience utilizing Healthcare Common Procedure Coding (HCPCS) and International Classification of Diseases (ICD) 10 billing codes.

Responsibilities

• Perform insurance verifications and authorizations for orthotic and/or prosthetic devices to ensure coverage for each code used for each device ordered for a patient.
• Collaborate with other team members and communicate requirements pertaining to their patient's insurance coverage.
• Communicate accurate benefits to the patient or applicable customer.
• Explain co-insurance and deductible amounts to patient or applicable customer and collect if possible.
• Process all authorization requests that are required by the patient's insurance carrier through live communication via phone with carrier's or using insurance carrier online portals to obtain the most up to date benefit information.
• Create patient account profile in the Medical Record system, manage the collection of medical documentation required to secure authorization for patient cases across all offices, and update patient file with appropriate notes accordingly.
• Communicate any changes in requirements for verification or authorization by insurance carriers to manager for training and compliance updates.
• Answer calls in a timely and professional manner and provide excellent customer service.
• Participate in training programs for continuing learning and development.
• Comply with Corporate Compliance and HIPAA responsibilities.
• Observe and communicate to management any opportunities to streamline processes and improve efficiency in day-to-day operations.
• Perform other duties and special projects as assigned.

Skills

Independent work ability

Task prioritization

Verbal and written communication

Organizational skills

Typing 45 wpm

Telephone etiquette

Problem-solving

Accuracy and timeliness

MS Office & databases

Medical billing experience

HIPAA & HIPAA regulations

HCPCS & ICD-10 coding experience

Education

High school diploma or equivalent

Associate degree in a relevant field (preferred)

Tools

MS Office

Databases

Job description

Ability Prosthetics & Orthotics is seeking a Verification of Benefits & Prior Authorization Coordinator to support clinics across Pennsylvania and Maryland. The role ensures accurate and timely prior authorizations and benefits verifications to facilitate patient care and billing processes.

The candidate should have strong communication skills, HIPAA awareness, and at least 2 years in medical billing, preferably in orthotics or prosthetics.