Verification and Authorizations Coordinator - NOT REMOTE

The Verifications and Authorizations Coordinator is responsible for determining insurance benefits and eligibility for our patients.

You will verify coverage for new patients and re-verify coverage for existing patients using our Phreesia software.

Computer skills are a must, you may be required to obtain authorization for procedures and services by calling insurance companies or accessing the online portals.

Applicants must have knowledge of medical terminology with understanding of CPT and ICD-10 Codes.

Major Responsibilities/Tasks:

• Use Phreesia to verify patient insurance benefits, eligibility, deductibles and copays
• Obtain prior authorizations for patient treatments and procedures
• Update EMR with amount owed by patient at time of service
• Update patient information into our system, as needed
• Ensure documentation is ready to submit for authorizations or verifications, per insurance requirements
• Contact PCPs for referrals, when necessary
• Properly handle denied verification/authorization cases and seek resolution through involved parties
• Coordinate processes and timing as required to meet physician and facility requirements
• Interact with patients’, physicians and other staff within the clinic and at outside facilities providing accurate, timely and responsive information
• Maximize office productivity through proficient use of software applications
• Research and develop resources that create timely and efficient workflow
• Maintain files and patient records in a confidential manner
• Perform other related duties as directed or assigned
• Assist with other administrative tasks as needed

Experience and Education:

• Minimum of one year of previous experience in medical authorizations or verifications
• Understanding of basic medical terminology a must
• Previous orthopedic, neurosurgery or pain management experience and/or experience with Athena Centricity EMR a plus
• High School Diploma or equivalent

Knowledge:

• Knowledge of clinic policies and procedures
• Knowledge of medical terminology and insurance practices
• Proficient with Microsoft Office Suite and similar computer programs
• Knowledge of grammar, spelling, and punctuation to type, review and edit reports, documentation and correspondence
• Knowledge of basic arithmetic to make calculations, balance and reconcile figures, and make changes accurately
• Knowledge of CPT and ICD-10 codes

Skills:

• Skill in operating office equipment
• Skill in handling paperwork/filing adequately
• Skill in handling incoming phone calls and triaging appropriately
• Skill in written and verbal communication
• Skill in gathering, interpreting, and reporting insurance information
• Skill in trouble-shooting insurance issues and resolving appropriately

Abilities:

• Ability to quickly learn and operate new computer software
• Ability to work effectively as a team member with physicians and other staff
• Ability to sort and file materials correctly by alphabetic or numeric systems
• Ability to interpret and understand insurance benefits and reimbursement
• Ability to flexibly respond to changing demands
• Ability to organize and prioritize tasks effectively
• Ability to communicate clearly
• Ability to work with little supervision
• Ability to establish and maintain effective working relationships with patients, employees, and the public

Work Environment: Work performed in office environment. Involves frequent contact with staff and occasional communication with patients.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.