Hybrid Eligibility & Authorization Specialist

Performance Ortho; Bridgewater (MA); Hybrid; USD 45,000 - 60,000; Full time

Job summary

Performance Ortho is seeking a Verification/Authorization Specialist to ensure accurate patient eligibility and secure necessary authorizations for services. The role requires collaboration with teams and payers while adhering to compliance regulations.

Applicants should have at least 2 years of related experience, strong analytical skills, and familiarity with insurance policies. Experience with eClinicalWorks is preferred. This position offers a full-time schedule with hybrid working options.

Qualifications

• Minimum of 2 years of experience in verification, authorization, eligibility determination, or a related healthcare role.
• Familiarity with orthopedic billing codes and payer requirements.
• Strong written and verbal communication skills.

Responsibilities

• Conduct detailed reviews of patient insurance coverage.
• Obtain pre-authorizations and referrals as required by insurance carriers.
• Maintain accurate records in EHR and billing systems.

Skills

Attention to detail

Analytical skills

Customer service

Problem-solving

Education

High school diploma or equivalent

Associate degree in healthcare administration

Tools

eClinicalWorks

Microsoft Office Suite

Job description

Performance Ortho is seeking a Verification/Authorization Specialist to ensure accurate patient eligibility and secure necessary authorizations for services. The role requires collaboration with teams and payers while adhering to compliance regulations.

Applicants should have at least 2 years of related experience, strong analytical skills, and familiarity with insurance policies. Experience with eClinicalWorks is preferred. This position offers a full-time schedule with hybrid working options.