Surgery Authorizations - Orthopedic​/Spine

Job Summary

Job Summary: Oversee all patient authorizations and related verification of insurance, procedure eligibility/coverage and patient benefit plan information. This position has unrestricted access to protected health information (PHI) pertaining to all patients.

• Obtain insurance verification and authorization from insurance companies via telephone call, facsimile or online program
• Document benefit coverage and patient’s out-of-pocket expenses on authorization/verification form
• Scan authorization and verification of patient eligibility, benefits and out-of-pocket expenses
• Communicate with patients regarding their out-of-pocket expenses and arrange payment plans when necessary
• Communicate with medical assistants regarding patient eligibility and scheduling of procedures
• Schedule appointments for procedures once eligibility has been determined and proper authorization has been obtained
• Document all necessary patient information and notes in computer system

• Responsible for promoting the Standards of Excellence for Orthopedic Specialists while demonstrating courteous and cooperative behavior toward patients, visitors, volunteers, peers and physicians
• Maintain a neat and orderly work environment, demonstrates the ability to organize and prioritize work during heavy workload situations to expedite patient care
• Maintain strictest confidentiality in accordance with HIPAA compliance
• Perform quality work within deadlines with or without direct supervision
• Work effectively as a team contributor on all assignments
• Work independently while understanding the need to communicate and coordinate work efforts with other employees and organizations

• High School diploma or GED required. Associates degree preferred
• Minimum of 2 years insurance and benefit experience
• Ability to perform essential duties
• Knowledge of medical insurance and billing
• Ability to identify and resolve collection issues
• Ability to document accounts clearly
• Computer Literate – Windows environment
• Knowledge of medical terminology
• Strong organizational skills
• Ability to perform basic mathematics
• Ability to clearly communicate written and verbal instructions
• Ability to efficiently manage multiple tasks and prioritize
• Ability to demonstrate proper telephone etiquette and computer skills

• Sitting long periods of time
• Manual dexterity sufficient to operate keyboard, calculator and other office equipment as necessary
• Ability to view computer screens for long periods of time

• Computer, scanner, printer, calculator, photocopier, facsimile, telephones

• Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this position. They are not intended to be an exhaustive list of responsibilities, duties and skills required of persons so assigned