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Surgery Authorization Specialist at HOPCo in Royal Palm Beach, FL
Skills
Job Description
Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise.
Center for Bone & Joint Surgery of the Palm Beaches is seeking a Surgery Authorization Specialist to obtaining authorizations, verifying eligibility and coordination of benefits and obtaining a cost estimate for surgical procedures.
ESSENTIAL FUNCTIONS · Monitors the authorizations of upcoming surgical cases on the physician’s calendars ensuring authorizations for surgeries are obtained in a timely and accurate manner. · Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans. · Accurately completes surgical cost analysis form, documenting the required surgical cost estimation for collection prior to services. · Verifies benefits on all surgical procedures. · Document authorizations and progress of authorizations in the patient’s chart. Enters the authorization information within case management. · Must be able to communicate effectively with physicians, patients, and co-workers and be capable of establishing good working relationships with both internal and external customers. · Participate in providing ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases. · Work with department manager to respond to and reduce complaints timely and professionally. · Assist surgery schedulers with STAT authorizations. · Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines. · Assists in identifying opportunities for improvement within the daily workflow process. · Attends department meetings as required.
EDUCATION · High school diploma/GED or equivalent working knowledge preferred.
EXPERIENCE · A minimum of 2 years of experience in the healthcare field is required and previous experience in referrals/authorizations, front office, and/or charge posting is preferred. · Excellent organizational skills and strong customer service orientation are required with a strong background in computers and data entry.
KNOWLEDGE · Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers, and other funding sources.
At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:
- Competitive Health & Welfare Benefits
- Monthly $43 stipend to use toward ancillary benefits
- HSA with qualifying HDHP plans with company match
- 401k plan with company match
- Employee Assistance Program that is available 24/7 to provide support
- Paid Time Off
- Paid Holidays
- and more...
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