Orthopedics Prior Authorization Specialist

Orthoconnecticut; Pine Rock Park (CT); Sur place; USD 30 000 - 34 000; Plein temps

Résumé du poste

OrthoConnecticut is seeking a Prior Authorization Specialist to obtain authorizations for viscosupplementation injections. You will liaise between patients, clinical staff, insurance carriers, and the Prior Authorization Team to facilitate approvals for procedures.

This full-time role requires 1–2 years in a physician group practice billing or prior auth environment, strong CPT/ICD10 knowledge, and excellent communication. Base pay ranges from $22.00 to $25.00 per hour, with no on-call duties.

Qualifications

• High school diploma required; college or trade school preferred.
• 1–2 years in a physician group practice billing or prior auth department.
• Certified Professional Coding certification helpful.

Responsabilités

• Verifies that medical necessity guidelines for each carrier are met based on documentation and CPT/ICD10 codes.
• Reviews the Prior Authorization requests in Summit Dashboard and Athena.
• Documents all pertinent information in the Summit Dashboard.
• Refer the patient to the Financial Counselor to determine financial responsibility prior to procedure.
• Maintains patient confidentiality and HIPAA compliance.
• Attends all regular Department meetings; performs other tasks as assigned by supervision.

Connaissances

CPT/ ICD10 knowledge

Communication skills

HIPAA compliance

Multitasking

Detail oriented

Professional demeanor

reven ue cycle management software

Formation

High school diploma

College/trade school preferred

Certified Professional Coding

Outils

Summit Dashboard

Athena

PM system

Description du poste

OrthoConnecticut is seeking a Prior Authorization Specialist to obtain authorizations for viscosupplementation injections. You will liaise between patients, clinical staff, insurance carriers, and the Prior Authorization Team to facilitate approvals for procedures.

This full-time role requires 1–2 years in a physician group practice billing or prior auth environment, strong CPT/ICD10 knowledge, and excellent communication. Base pay ranges from $22.00 to $25.00 per hour, with no on-call duties.