Insurance Pre-Authorization Coordinator

Summit Spine and Joint Centers; Lawrenceville (GA); On-site; USD 36,000 - 56,000; Full time

Job summary

Summit Spine and Joint Centers in Lawrenceville, GA seeks an Insurance Pre-Authorization Coordinator to manage surgical pre-authorizations, communicate with insurers, and support patients. The role requires 2+ years in outpatient medical offices and EMR/EHR experience.

You will review schedules, handle deductibles and copays, and maintain organized authorization files while delivering excellent customer service in a fast-paced practice.

Qualifications

• Minimum of 2 years' experience in an outpatient medical office in an Insurance Authorization or Pre-Authorization/Certification role.
• Excellent knowledge of CPT coding and ICD-10 coding.
• Authorization portal experience required.
• Experience in Pain Management Authorizations required.
• EMR/EHR experience is required.

Responsibilities

• Obtain insurance authorizations for surgical procedures by using online applications or by contacting insurance company directly.
• Address insurance related patient concerns
• Coordinate and document all financial responsibilities related to patient deductibles, coinsurance, and copays owed at the time of service.
• Maintain organized working files of all authorization requests and enter approved authorizations into the system.
• Review schedule ahead of time to determine pre-certification and prior authorization requirements.
• Other Insurance duties as assigned

Skills

Personable

Detail oriented

Verbal communication

Written communication

CPT ICD-10 coding

Bilingual

Tools

Authorization portal experience

EMR/EHR experience

Job description

Position: Insurance Pre-Authorization Coordinator

Location: Lawrenceville, GA

Job Id:4433

# of Openings:1

Company Overview:

Summit Spine and Joint Centers (SSJC) is a rapidly growing, multi-state Interventional Pain Management group practice providing integrated clinical, surgical, and imaging services. With clinic locations across Georgia, North Carolina, South Carolina, and Tennessee, our care teams include Integrated Pain Solutions in North Carolina and Savannah Pain Management in Georgia, all operating as part of the SSJC organization. As one of the largest single-specialty practices in the nation, we are committed to collaboration, high-quality patient-centered care, and supporting our teams as we continue to expand. We are seeking motivated, qualified professionals to join us in delivering exceptional care across our growing network.

Job Description Summary:

Under general supervision of a licensed provider, as an Insurance Authorization Coordinator one must be detail oriented with excellent phone call diction, and outstanding customer service skills. We are seeking motivated individuals who can problem-solve and multitask as we are a fast-paced practice. Gain skills and knowledge of organization policies and procedures in support of the department. This job is a full-time, benefited position at Summit Spine & Joint Centers that reports to the Insurance Manager.

Responsibilities:

• Obtain insurance authorizations for surgical procedures by using online applications or by contacting insurance company directly.
• Comfortable working in a growing organization and able to navigate change.
• Address insurance related patient concerns
• Self-motivated with the ability to multi-task and prioritize work in a fast-paced team environment
• Review schedule ahead of time to determine pre-certification and prior authorization requirements.
• Must be familiar with Medicare and Commercial Insurances.
• Maintain organized working files of all authorization requests and enter approved authorizations into the system.
• Coordinate and document all financial responsibilities related to patient deductibles, coinsurance, and copays owed at the time of service.
• Other Insurance duties as assigned

Skills And Abilities:

• Must be personable and detail oriented as a representative of the practice while callers rely on proper information
• Excellent verbal and written skills for proper documentation of encounters.
• Bilingual candidates are encouraged to apply

Education And Experience:

• Minimum of 2 years' experience in an outpatient medical office, working in an Insurance Authorization or Pre-Authorization/Certification role.
• Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required
• Authorization portal experience required
• Experience in Pain Management Authorizations required
• EMR/EHR experience is required.

The employee must communicate professionally, respectfully, and effectively with patients, visitors, clinicians, coworkers, and vendors, including in busy, demanding, or stressful circumstances. The employee must maintain professional composure and consistently perform assigned duties throughout the scheduled work period; manage routine workplace stressors and feedback without disrupting patient care, patient-facing operations, or coworkers’ work; and use established de-escalation and escalation procedures when appropriate. The employee must exercise sound judgment; maintain appropriate workplace boundaries; receive and respond to routine feedback and direction; protect confidential patient and business information; and address patient or workplace concerns through established supervisory and safety procedures. These functions are essential to the position.