Senior Insurance Authorization & Eligibility Specialist

OrthoArizona; Chicago (IL); On-site; USD 52,000 - 68,000; Full time

Benefits offered by this job

Robust PTO (sick time, holidays, PTO)

Medical options

Health Savings Account with company

Job summary

OrthoArizona seeks a Senior Authorization & Eligibility Representative to verify insurance coverage, obtain referrals, and coordinate with patients and providers. You will navigate multiple portals, maintain accurate records in PM/EMR systems, and ensure timely processing of claims.

The role requires strong communication skills, knowledge of insurance plans, and the ability to work with various teams in a fast-paced orthopedic practice environment.

Qualifications

• Knowledge of medical terminology.
• Experience in healthcare administration.
• Ability to navigate insurance authorizations.
• Strong communication, both written and verbal.
• Proficiency with practice management software.

Responsibilities

• Verify insurance coverage for potential new patients and add-ons and re-verify for existing patients.
• Navigate insurance portals or by phone to obtain benefits.
• Reconcile information in PM system, EMR, and Phreesia for claim processing.
• Obtain referrals and authorizations for Physical Therapy patients as required.
• Act as liaison between patients, providers, and insurance carriers.
• Enter authorization numbers and expiration dates into PM, EMR, and Phreesia.
• Update insurance notes in multiple EMR systems for access by departments.
• Maintain medical records per practice policies.

Skills

Medical terminology

Computer programs

Written and verbal communication

Practice management software

Promote facility image

Telephone communication

Decision making & problem solving

Health insurance plan knowledge

SOP adherence

Healthcare administration experience

Organizational skills

Teamwork & independence

Meeting metric deadlines

Education

High School diploma or GED

Tools

Centricity Software

Phreesia

Job description

OrthoArizona seeks a Senior Authorization & Eligibility Representative to verify insurance coverage, obtain referrals, and coordinate with patients and providers. You will navigate multiple portals, maintain accurate records in PM/EMR systems, and ensure timely processing of claims.

The role requires strong communication skills, knowledge of insurance plans, and the ability to work with various teams in a fast-paced orthopedic practice environment.