Insurance Authorization Specialist

EXCELSIOR ORTHOPAEDICS GROUP in; Town of Amherst (NY); In loco; USD 28.000 - 39.000; Tempo pieno

Descrizione del lavoro

Excelsior Orthopaedics Group in Amherst, NY is seeking a Full-Time Medical Billing Specialist to obtain pre-authorizations, verify orders, and manage authorization data across our billing systems. You will work closely with clinicians, payers, and staff to ensure accurate and timely processing.

Candidates should have a high school diploma, knowledge of CPT/HCPCS/ICD-10, medical terminology, and EMR experience (MEDENT preferred).

Competenze

• High school degree or equivalent.
• Knowledge of CPT, HCPCS, and ICD-10 codes strongly preferred.
• Medical terminology knowledge required.
• EMR experience preferred (MEDENT).

Mansioni

• Obtains pre-authorizations/pre-certification per payer requirements and documents in the system.
• Verifies physician orders are accurate.
• Communicates insurance co-pays, deductibles, co-insurances, and out-of-pocket expenses.
• Keeps providers, clinical staff, and patients informed about authorization status.
• Researches and resolves rejected or denied claims with the billing department.
• Maintains a professional atmosphere for patients, family members and staff.
• Keeps current with insurance requirements for pre-authorization and educates departments on changes.
• Informs management of changes in authorization processes and billing policies.

Conoscenze

EMR experience

Medical terminology

Attention to details

Multitasking

Formazione

High school diploma or equivalent

Strumenti

MEDENT EMR

Descrizione del lavoro

Job Details: Job Location: EXC Amherst NY - Amherst, NY 14226, Position Type: Full Time, Salary Range: $20.00 - $28.00 Hourly, Job Summary

Obtains pre-authorizations/pre-certification per payer requirements for services rendered and ensures authorization information is documented in the appropriate system. Your knowledge of insurance carriers and specific plan details will make you a valuable resource to patients, providers, and coworkers! Knowledge of medical codes and medical terminology required.

Duties and Responsibilities

• Obtains pre-authorizations/pre-certification per payer requirements for services rendered and ensures authorization information is documented in the appropriately in the system.
• Verifies physician orders are accurate.
• Ability to understand and communicate insurance co-pays, deductibles, co-insurances, and out of pocket expenses for point of service collections.
• Communication is maintained with providers, clinical staff, and patient in relationship to authorization status.
• Works and assists with the billing department in researching and resolving rejected, incorrectly paid and denied claims as requested.
• Helps to maintain a professional atmosphere for patients, family members and staff.
• Remains current with insurance requirements for pre-authorization and provides education within the departments and clinics on changes.
• Keep management informed of changes in authorization process, insurance policies, billing requirements, rejection or denial codes as they pertain to claim processing and coding.

Qualifications: Requirements and Qualifications

• High school degree or equivalent.
• Knowledge of CPT, HCPCS, and ICD-10 codes highly preferred.
• Medical terminology required.
• Ability to prioritize and perform multiple tasks with many interruptions.
• EMR experience required; MEDENT preferred.

Physical Demands

• Requires prolonged sitting and/or standing; primarily using phone and computer.
• Position requires manual and finger dexterity and hand-eye coordination.
• Involves standing, sitting, and walking.
• Team member will occasionally be asked to lift and carry items weighing up to 10 pounds; normal visual acuity and hearing are required.

The pay range for this position is determined based on several factors, including the candidate’s years of experience, qualifications, training, licenses, designations, and the overall market conditions.

This job description does not state or imply that the duties and responsibilities listed are the only ones required of this position. Team members in this role will be required to perform other job-related duties at the discretion of the employer and may have additional duties assigned as necessary.

Excelsior Orthopaedics and Buffalo Surgery Center are committed to the full inclusion of all applicants. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information.