What are the responsibilities and job description for the Associate - Pre-Authorization position at Orthopedic Associates of Manhasset?
Who we are : 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, Spire Orthopedic Partners is a growing partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices in todays evolving healthcare landscape. 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 youll do :
The Pre Authorizations Associate would be responsible for daily authorization, benefits and follow-up. The incumbent serves as the OAM internal subject matter expert on all matters including communicating with patients and insurance companies.
Responsibilities / Duties :
Works effectively with insurance companies to get pre-authorization completed in a timely manner.
Communicates effectively and routinely with clinical staff on the status of the pre-authorization; and documents the pre-authorization approval or denial through the EMR. Follows up with staff and clinicians accordingly.
Prioritizes workload and develops system to track prior authorizations needing additional follow-up.
Takes personal responsibility for work. Fosters teamwork, taking the initiative to teach pre-authorization team members, clinic staff, and management about pre-authorization processes and insurance requirements
Communicates effectively with other staff at outside facilities.
Completes benefits investigations as needed.
Navigate through the EMR to find the required patient medical information.
Maintains confidentiality of patient records.
Other duties as assigned.
Who you are : Qualifications :
Qualified candidates must possess the ability to analyze, retain, and resolve issues and provide superior customer service to client base.
Able to work independently and productively, be organized and cooperative under stressful conditions.
Ability to be a team player, communicate effectively and meet deadlines.
Associates degree preferred, high school diploma / equivalent required.
A Minimum of two years' experience preferred in the health care industry experience.
What we offer :
Excellent growth and advancement opportunities
Dynamic environment
Access to a diverse network of practitioners
Broad infrastructure of tools and programs to enhance the employee experience
Competitive Compensation
Generous PTO
Benefits 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).
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