Eligibility and Benefits Specialist

OrthoArizona; Peoria (AZ); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Robust paid time off

Medical insurance

Health Savings Account

Dental & Vision insurance

401(k)

Employee discount

Job summary

OrthoArizona in Peoria, AZ is seeking an Eligibility & Benefits Specialist to verify patient insurance, manage referrals, and ensure accurate claim processing. You will interact with patients, providers, and carriers to gather required information and keep EMRs up to date.

Candidates should have strong customer service, healthcare administration experience, and knowledge of medical terminology. The role includes on-site training and benefits such as PTO, health plans, and a 401(k).

Qualifications

• Excellent customer / patient service.
• Must be able to drive to location for in-person training period for first 90 days and as needed after.
• 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.
• Knowledge of medical terminology and insurance authorization processes.

Responsibilities

• Verify insurance coverage for potential new patients and re-verify insurance coverage for existing patients.
• Navigates through multiple insurance portals or by phone to obtain necessary insurance benefits.
• Reconciles obtained information within EMR to ensure successful claim processing.
• Responsible for obtaining all referrals and authorizations for office visits, 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.
• Enters any authorization numbers and expiration dates into the EMR 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.

Skills

Customer service

Medical terminology

Communication skills

Practice management software

Telephone communication

Education

High School diploma or GED

Tools

EMR systems

Job description

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.

Eligibility & Benefits Specialist

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 Eligibility & Benefits Specialist with OrthoArizona, you will get to:

• Verify insurance coverage for potential new patients and re-verify insurance coverage for existing patients.
• Navigates through multiple insurance portals or by phone to obtain necessary insurance benefits.
• Reconciles obtained information within EMR to ensure successful claim processing.
• Responsible for obtaining all referrals and authorizations for office visits, 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.
• Enters any authorization numbers and expiration dates into the EMR 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.

Qualifications

• Excellent customer / patient service.
• Must be able to drive to location for in-person training period for first 90 days and as needed after.
• 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.
• Knowledge of medical terminology and insurance authorization processes.

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.
• Dental & Vision insurance.
• 401(k)
• Pet Discount Plan.
• ID Theft protection & Legal assistance.