Pre-Authorization Specialist: Streamline Patient Access

EXCELSIOR ORTHOPAEDICS GROUP in; Town of Amherst (NY); Sur place; USD 28 000 - 39 000; Plein temps

Résumé du poste

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).

Qualifications

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

Responsabilités

• 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.

Connaissances

EMR experience

Medical terminology

Attention to details

Multitasking

Formation

High school diploma or equivalent

Outils

MEDENT EMR

Description du poste

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).