Authorization Specialist

Job Category Non-Clinical Employee Type Full-Time Description Join EmergeOrtho as an Authorizations Specialist! EmergeOrtho is committed to being the trusted leader in innovative, quality-focused comprehensive musculoskeletal care. With offices across North Carolina, the Coastal region is seeking an Authorizations Specialist to join their team in our Shipyard office. The Authorizations Specialist is responsible for obtaining and applying all required authorizations, enabling the appropriate compensation for medical claims. Confirms patients’ insurance eligibility while obtaining authorization. The specialist acts as a liaison between referring physicians’ offices, case managers, adjusters, and social workers to obtain required authorizations. Why Join EmergeOrtho? Great Team - Join a collaborative, supportive group that values your contributions Hands-On Training - Broaden your skill set and grow your career with hands-on training Full-Time Schedule - Enjoy the stability and consistency of a full-time position with regular hours Who Should Apply? If you're a detail-oriented professional who excels in a dynamic healthcare environment, values teamwork, and is passionate about ensuring patients receive timely and accurate care through efficient authorization processes, we want to hear from you! Be part of something bigger - apply today and help streamline the future of patient access and care coordination! Qualifications and Experience High school diploma or equivalent Previous experience in insurance billing and coding Minimum two years of patient service experience in a healthcare setting Ability to act with integrity, professionalism, and confidentiality Experience using electronic medical records systems Excellent communication and interpersonal skills Excellent organizational skills and attention to detail Responsibilities Obtains orders from the physician Log all orders in EMR for accurate tracking and scheduling Eligibility, benefits, and authorization are obtained online or via telephone Respond to clinical requests by providing accurate information. Perform follow-up calls within 3 business days regarding the authorization status If a peer-to-peer review is needed prior to obtaining authorization, schedule with our physician and the insurance carrier’s Medical Director If the request is to have the patient be sent to an outside physician for treatment the office notes, patient demographics, and insurance card(s) are faxed to the outside physician’s office for an appointment Follow up on requests within 7-10 days to confirm accurate information has been received and confirm an appointment has been made Work diagnostic orders within 3-5 days of receipt. STAT orders are worked on immediately Obtain surgical authorizations 10 days prior to the surgery date unless the surgery is scheduled as a STAT Maintain the electronic log sheet, generated for physical therapy patients indicating patient demographics and therapy caps Maintains clinic and patient confidentiality Performs other duties as required and assigned by Manager, including schedule changes and travel to office locations as assigned Available benefits based on hours worked per week. EmergeOrtho, P.A. complies with applicable civil rights laws and does not discriminate based on race, color, religion, national origin, age, sex, gender identity or expression, sexual orientation, pregnancy, childbirth and related conditions, including but not limited to lactation, disability, veteran status, genetic information, or any other class protected by the state or local law. #J-18808-Ljbffr