What are the responsibilities and job description for the Prior Authorization Specialist position at Stevens Point Orthopedics?
Why SPO?
Are you a Prior Authorization Specialist looking to join a collaborative team dedicated to helping people get back to living life pain-free? Then Stevens Point Orthopedics (SPO) is the place for you!
The SPO motto—World Class Treatment…Hometown Care—resonates throughout the walls as the entire team is committed to getting the central Wisconsin community back to doing the things they love with modern technology and authentic compassion. Upon hire, you would experience the same environment where empathy and expertise come together to provide the highest standard of quality healthcare. In addition to a full benefits package, a computer, and the equipment necessary to work in this role would also be provided, as this is a hybrid position.
If you share a similar goal, we’d love for you to join our team and provide patients and the community with outstanding healthcare.
Job Summary
The Prior Authorization Specialist will assist Stevens Point Orthopedics with obtaining prior authorizations for patient procedures. The Prior Authorization Specialist provides detailed and timely communication to both the payers and clinical partners to facilitate compliance with payer requirements and is responsible for documenting the appropriate information in the patient’s records. The individual performs in a manner consistent with Stevens Point Orthopedics’ mission, policies, and initiatives while always maintaining patient confidentiality.
Essential Job Functions
- Gather patient insurance benefit information through online portals and/or telephone.
- Obtain prior authorization from insurance and document it within patient charts in an electronic medical records system.
- Ensure timely and accurate insurance authorizations are in place before services are rendered.
- Maintain detailed records of all prior authorizations completed and document them in an organized Excel spreadsheet.
- Assist with insurance claims follow-up and other billing duties.
- Communicate regularly with receptionists, billing staff, and clinical staff regarding patient accounts.
- Appropriately prioritize workload to ensure the most urgent cases are handled promptly.
- Maintain a professional environment.
- Always uphold confidentiality and HIPAA compliance.
Job Qualifications
Minimum Required:
- High school diploma or equivalent.
- Knowledge of medical terminology.
- Previous experience working in modern medical office practices or in patient care.
- Previous experience working in medical billing/prior authorization.
- Must have reliable, private internet access to work remotely from home.
Special Skills/Experience
- Previous experience working with Microsoft Excel.
- Previous experience working in orthopedics and spine specialties is a plus.
- Communicating clearly and concisely, orally and in writing.
- Excellent typing and computer skills.
- Ability to work independently to complete assigned work in a timely manner.
- Ability to communicate with staff and providers, both in person and over the telephone, in a tactful manner and under difficult situations.
- Understanding and carrying out verbal and written directions.
- Detail-oriented.
Stevens Point Orthopedics strives to exceed expectations by providing exceptional patient care in a pleasant and caring atmosphere. We believe that teamwork, flexibility, mutual trust, and cooperation are essential to healthcare delivery. Successful applicants will share our values and put the needs of patients and customers first.
Stevens Point Orthopedics is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
Job Type: Full-time
Pay: $23.00 - $30.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Work Location: Hybrid remote in Stevens Point, WI 54481
Salary : $23 - $30