Authorization and Referral Coordinator
About OrthoArizona:
At OrthoArizona, we are bringing the best together. Our organization was created to help serve ALL orthopedic and sports medicine needs throughout the Valley! We have a wide range of orthopedic surgeons and mid-level providers. Our mission is to provide excellent, compassionate care to our patients, their families, and visitors.
As an Authorization and Referral Coordinator with OrthoArizona, you will get to:
- Answer phone in prompt, courteous and helpful manner, screening, and routing calls as needed.
- Creates phone notes in the patient's electronic medical record, and/or provides information to patients.
- Register patients in EMR as applicable.
- Confirm patient demographics and paperwork for accuracy, completion, and missing information.
- Verify insurance eligibility and benefits in accordance with patient insurance coverage for all patient office encounters and referral orders.
- Ensure proper clinical chart documentation is present for all patient office encounters and for all referral orders.
- Obtain prior authorization and/or referrals in accordance with patient insurance coverage for all patient office encounters and referral orders prior to services being rendered.
- Accurately calculate any estimated patient out of pocket costs for services, communicate all out-of-pocket costs to patient, and collect prior to services being rendered.
- Document the authorization status properly in all applicable areas of EMR.
- Build accurate Case Management in EMR and attach appropriate CM as indicated.
- Notify all applicable staff as to status/completion of above processes.
- Courteously interact with patients, family members, visitors, and members of the health care team; directs patient questions and/or concerns to appropriate department; keeps patients informed of auth/referral status.
- Schedule patients for follow-up office visits or procedures, log no-show appointments; assist in indexing all document management images as indicated.
- Maintain medical records in accordance with practice policies and procedures.
- All other duties as assigned.
Qualifications:
- Excellent customer / patient service.
- Knowledge of medical terminology.
- Working knowledge of computer programs.
- Excellent written and verbal communication skills.
- Understand/Perform training on practice management software.
- Ability to promote favorable facility image with physicians, patients, insurance companies, and general public.
- Ability to communicate effectively on the telephone.
- Ability to make decisions and solve problems.
- Working knowledge of health insurance plans including reading plan requirements.
- Follow all Standard Operating Procedures.
Minimum Qualifications
- High School diploma or GED.
- 3 – 5 years medical front office, billing, or other administrative experience; and
- Proficiency in authorizations, eligibility, and benefits in a medical office setting.
Preferred Qualifications
- More than 3 years of direct experience and proficiency in authorizations, eligibility, and benefits in a medical office setting.
- Bilingual is a plus.
Full Time Benefits:
- Robust paid time off package including, sick time, holidays, & paid time off!
- Medical - including a plan with 100% employer coverage- a $585 monthly value.
- Health Savings account + company contributions.
- Dental & Vision insurance.
- Company paid life insurance policy + the option to purchase additional benefits to protect you from what life throws at you.
- 401(k) with a company contribution + profit sharing!
- Pet insurance.
- ID Theft protection & Legal assistance.