Description:
Job Overview: The Advanced Imaging Authorization Specialist is crucial in managing the pre-authorization of imaging orders within the practice. This role includes verifying insurance benefits for pre-certification, obtaining necessary pre-authorizations from payors, and counseling patients on their financial responsibilities related to scheduled treatments. The position is also responsible for reviewing the authorization status of scheduled patients and rescheduling imaging studies as necessary to ensure completed authorization.
Department: Administrative
Reports to: Billing Manager
Schedule/Type: FT - onsite/hourly M-F
Wage: $20-32/hr, commensurate with experience
Bonus Eligibility: No
Requirements:
Essential Duties:
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Submit authorization requests and follow up with insurance companies for all STAT, outside facility, and workman’s compensation imaging orders.
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Upon receiving orders from the surgeon, verify order contents and insurance coverage, obtain pre-authorization, and communicate benefit eligibility and other financial issues with the involved parties.
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Notify patients and practitioners of any services requested and/or referred that are not authorized by insurance.
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Review upcoming MRI/CT schedules for authorization status and contact patients with payment/rescheduling options when authorization has not been received.
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Effectively utilize intraoffice communication and resources to obtain necessary information relating to the authorization process.
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Prioritize workflow based on knowledge of authorization timeframes, insurance requirements, and other determinants of urgency.
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Obtain retroactive authorization as needed.
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Maintain timely, complete documentation and record keeping to ensure accurate continuity of patient care.
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Execute other duties as assigned by department leadership with a high level of organization and attention to detail.
Requirements:
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Education: High school diploma or general equivalency diploma (GED) required; college degree preferred.
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Experience: Minimum of 2 years of billing/authorization experience, preferably in an orthopedic or medical setting. Previous experience in pre-authorization/pre-certification and processing of health insurance claims is preferred.
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Skills and Knowledge:
- Knowledge of insurance and third-party payers.
- Understanding of basic coding, including CPT and ICD-9 coding.
- Familiarity with current Medicare Compliance, OSHA, and HIPAA regulations.
- Excellent written and verbal communication skills and strong customer service abilities.
- Proficiency in medical record systems and standard office equipment, including computers, fax machines, copiers, and printers.
- Ability to prioritize, multi-task, and work well in a fast-paced environment.
- Physical Requirements: Combination of sitting, standing, bending, light lifting, and walking. Requires a full range of body motion, including manual and finger dexterity and hand-eye coordination. Requires corrected vision and hearing to a normal range. Ability to manage stressful situations is essential.
Company Paid Benefits
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Employee HDHP Plan
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Basic Life/AD&D –Guardian
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16 days of PTO per year
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7-7.5 paid holidays per year
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EAP
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401K Safe Harbor Contribution
Benefit Options Requiring Employee Contributions
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Medical
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HAS and FSA
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Dental
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Vision
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Short-Term Disability
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Voluntary Life and AD&D
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Flex Spending Accounts
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General Purpose Healthcare FSA
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Optional Protection Benefits (Accident, Hospital Indemnity, Cancer Care and Critical Illness Insurance)
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401(k)
Closing Date: July 22nd, 2024
Boulder Centre for Orthopedics is proud to be an Equal Opportunity employer. We are committed to providing equal employment opportunities to all qualified individuals without regard to race, color, religion, sex, national origin, age, disability, genetic information, marital status, sexual orientation, gender identity or expression, veteran status, or any other characteristic protected by applicable law. Our hiring decisions are based solely on qualifications, merit, and business needs. We encourage diverse candidates to apply and welcome the opportunity to build a talented and inclusive workforce. In our recruitment and employment practices, we adhere to applicable federal, state, and local laws, ensuring fairness and inclusivity in all aspects of employment. We value diversity and believe that a diverse workforce enhances our ability to serve our patients and community effectively. All qualified individuals are encouraged to apply, regardless of background or identity.