RCM Authorizations Representative

Spire Orthopedic Partners; Stamford (CT); Vor Ort; USD 25.000 - 39.000; Vollzeit

Benefits dieser Stelle

Competitive Compensation

Generous PTO

Benefits package

Zusammenfassung

Spire Orthopedic Partners, a growing MSO headquartered in Stamford, CT, seeks an Authorization Specialist to support orthopedic practices across the Northeast. You will review orders in the EHR, determine authorization requirements, and coordinate with outsourcing vendors to ensure timely approvals and patient care.

Ideal candidates bring at least one year of prior authorization experience, solid communication skills, and familiarity with EMR and practice management software.

Qualifikationen

• Minimum of one-year prior authorization experience required.
• Excellent telephone etiquette and strong communication skills (written and oral).
• Familiar with Local Coverage Insurance Plans.

Aufgaben

• Review orders and necessary dictations in EHR regarding authorization requirements.
• Maintain auth team task list and ensure timely turnaround with outsourced authorization companies.
• Coordinate with Dir. of Operations, Office Managers and PCCs on scheduling and workflow changes.
• Serve as main contact for provider correspondence and patient issues while maintaining confidentiality in EMR.

Kenntnisse

Prior authorization

Orthopedic knowledge

Communication skills

EMR familiarity

Detail oriented

Ausbildung

High school diploma or equivalent

Tools

EMR

Practice management software

Microsoft Word

Excel

Jobbeschreibung

Who we are:Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Headquartered in Stamford, Connecticut, the Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts.What you’ll do:Responsibilities/Duties:Review the EHR task lists for the following services/tests to determine authorization requirements:Commercial SurgeryPhysical TherapyMRI/CT ScansInjections/VISCODME/Bone StimulatorsReview all orders and necessary dictations in EHR regarding request.Keep each list updated to ensure timely requests are sent.Document all correspondence/updates on each order with the status as it becomes available.Notify providers and arrange Peer to Peer requests and follow up on outcome.Notify Clinical and Radiology staff of any changes with authorization requirements.Act as the direct point of contact for outsourced authorization companies to ensure appropriate turnaround times are being supported per contract.Communicate scheduling needs with the Dir. Of Operations, Office Managers and PCC’s.Act as a resource for the team, be the first line response to procedural and workflow issues and keep the staff informed of procedure and workflow changes.Maintain auth team task list.Maintain a professional work atmosphere through behavior and communication with patients, physicians, coworkers and administration.Works directly with RCM and Operational Teams to ensure proper scheduling and patient care. Includes monitoring team communication and decision making.Creates, updates, and accesses confidential patients’ data in EMR with high level of confidentiality and accuracy.Main contact for all Provider correspondence and patient issues.Demonstrate the ability to prioritize and multi-task.Who you are:Qualifications:Minimum of one-year prior authorization experience required.Knowledge of Orthopedic procedures help, but not essential.Excellent telephone etiquette and good communication skills (written and oral).Computer literacy skills preferred, including practice management software, EMR, Microsoft Word and Excel.Detail oriented and strong organizational skills preferred.High school diploma or equivalent.Familiar with Local Coverage Insurance PlansWhat we offer:Excellent growth and advancement opportunitiesDynamic environmentAccess to a diverse network of practitionersBroad infrastructure of tools and programs to enhance employee experienceCompetitive CompensationGenerous PTOBenefits package: health, dental, vision, 401(k), etc.We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”).