Complex Case Insurance Authorization Coordinator

Complex Case Insurance Authorization Coordinator

Under general supervision of a licensed provider, as a Complex Case Insurance Authorization Coordinator one must perform insurance authorizations for complex surgical procedures such as SCS trials and implants, Vertiflex implants, SI Joint Fusions, NALU/Sprint Peripheral Nerve Stimulators, Intracepts, VIA DISCs, etc. We are seeking motivated individuals who can problem-solve and multitask as we are a fast-paced practice. Gain skills and knowledge of organization policies and procedures in support of the department.

This job is a full-time, benefited position at Summit Spine & Joint Centers that reports to the Director of Operations. This position's primary location will be at the Administrative Building in Lawrenceville, GA.

Responsibilities

• Routinely provide patients with other clinic and community-based resource materials as appropriate.
• Research, follow up and resolve open & pending procedure authorizations in a timely manner
• Verify insurance eligibility and benefits of prospects/referrals
• Comfortable working in a growing organization and able to navigate change.
• Address insurance related patient concerns
• Self-motivated with the ability to multi-task and prioritize work in a fast-paced team environment
• Review schedule ahead of time to determine pre-certification and prior authorization requirements.
• Obtain authorizations by using online applications or by contacting insurance company directly.
• Must be familiar with Medicare and Commercial Insurances.
• Maintain organized working files of all authorization requests and enter approved authorizations into the system.
• Coordinate and document all financial responsibilities related to patient deductibles, coinsurance, and copays owed at the time of service.

Skills And Abilities

• Must be personable and detail oriented as a representative of the practice while callers rely on proper information
• Excellent verbal and written skills for proper documentation of encounters.
• Bilingual candidates are encouraged to apply

Education And Experience

• Minimum of 2 years' experience in an outpatient medical office, working in an Insurance Authorization or Pre Authorization /Certification role.
• Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required
• Authorization portal experience preferred
• Experience in Pain Management preferred
• Experience using eClinicalWorks preferred