Patient Financial Services Coordinator/Prior Authorization Specialist

Patient Financial Services Coordinator/Prior Authorization Specialist

At Summit Orthopedics, we recognize the significance each member of the Summit Family has as they impact one another and our patients on a daily basis. Be part of a patient-first environment that lives into our values of: Compassion, Integrity, Excellence, Collaboration, Stewardship and Innovation and a place where staff members feel respected and find a strong sense of purpose in their roles, contributing to a familial atmosphere characterized by mutual respect and enjoyment.

The Patient Financial Services Coordinator (PFSC) is responsible for verifying patients' eligibility and benefits, obtaining authorization and/or referrals for patient encounters/procedures from their insurance company or referring provider; gathering current out-of-pocket and deductible information, securing patient responsibility prior to services and managing charity care and/or discount requests. This is a full time role based at our Corporate Office in Woodbury, MN. Monday - Friday schedule of 8:00 AM to 4:30 PM. Required training is in office with the ability to work from home once fully trained. This role will follow-up with the intent of collecting all delinquent unpaid insurance and patient account balances.

Primary job duties for the Patient Financial Services Coordinator:

• Create payment arrangements for uninsured patients and patients on high-deductible plans for all physician visits prior to services.
• Verify by phone, web, or in writing the prior authorization expectations as well as eligibility of the patients' insurance for the following medical encounters/procedures MRIs-using decision tools and phone/internet when necessary Work Comp, Auto, Med Legal and any other required referral clinic visits
• Professional Fee for surgical procedures as well as facility fee for procedures performed at Summit locations
• Obtain and enter pre-certification and/or prior authorization numbers into the registration fields and scan in Practice Management/EHR software.
• Review and correct discrepancies in registration and insurance information and update in the Practice Management Software at time of authorization.
• Assist patient with medical assistance and charity care applications, counsel patients on options such as care credit.
• Maintain current knowledge regarding third-party and first-party payment procedures and regulations as well as preferred provider agreements.
• Communicate professionally with patient, family members, co-workers and physicians.

Summit's hiring range for this position is $20.64 to $25.80 per hour. The hired candidate may be eligible to receive additional compensation in the form of bonuses, differentials and/or deferred compensation. In addition to our base salary, we offer a comprehensive total rewards package that aligns with our vision of leading a healthy and active lifestyle. This includes medical, dental, vision, disability, life insurance, paid time off and 401(k)/profit sharing retirement plan.

If you are hired at Summit, your final base salary compensation will be determined based on factors such as skills, education, experience, and internal equity. Summit Orthopedics provides the Twin Cities, Greater Minnesota and Western Wisconsin with the full spectrum of orthopedic care including sub-specialty clinics, walk-in care at our Orthopedic Urgent Care clinics, imaging, bracing, therapy, surgery, and post-surgical stays at our Care Suites. Our expert team of physicians, surgeons, physician assistants, certified athletic trainers and therapists are part of the 1200+ employees who partner to provide quality care designed to support a healthier, more active lifestyle. Summit Orthopedics is committed to providing equal opportunity to all employees and applicants for employment in accordance with all applicable laws and regulations of federal, state and local governing boards and/or agencies.

Qualifications

Education:

High School or better. Associates or better preferred.

Experience:

Experience with medical software (PM, EHR, or EMR). Extensive knowledge of third-party and government payer practices and requirements. Minimum of 1 year of experience in insurance verification/eligibility and/or insurance authorization, as well as experience having discussions with patients regarding out-of-pocket expenses.