Ortho Authorization Liaison: Fast Referrals & Payor

Nemours Children's Health; Wilmington (DE); On-site; USD 50,000 - 70,000; Full time

Job summary

Nemours Children's Health is looking for an Orthopedic Authorization Liaison in Wilmington, DE. The role focuses on optimizing payment services through effective management of referrals and authorizations for orthopedic patients. Strong knowledge of insurance processes and communication with families is essential.

Ideal candidates will have at least five years of experience in referrals or authorizations and relevant certifications. Join a leading pediatric health organization dedicated to improving children's health and delivering exceptional care.

Qualifications

• Minimum five years of referral and/or authorization experience is required.
• Ability to work with non-participating insurance structures.
• Must demonstrate effective communication with families and healthcare providers.

Responsibilities

• Optimize payment by processing referrals and authorizations for orthopedic patients.
• Maintain confidentiality and verify patient demographics and financial responsibilities.
• Document all communications accurately and fulfill backup role as needed.

Skills

Knowledge of participating and non-participating insurances

Billing and medical terminology

Data analysis and tracking

Effective communication

Education

High School Diploma or equivalent

Associate’s Degree preferred

Certified Revenue Cycle Representative (CRCR)

Certified Healthcare Financial Professional (CHFP)

SuperUser certification

Tools

EPIC applications

Job description

Nemours Children's Health is looking for an Orthopedic Authorization Liaison in Wilmington, DE. The role focuses on optimizing payment services through effective management of referrals and authorizations for orthopedic patients. Strong knowledge of insurance processes and communication with families is essential.

Ideal candidates will have at least five years of experience in referrals or authorizations and relevant certifications. Join a leading pediatric health organization dedicated to improving children's health and delivering exceptional care.