Prior Authorization Spec. / Financial Counselor- Texas Orthopedics at ORTHOLONESTAR

Austin, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

20 Mar, 26

Salary

24.0

Posted On

20 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Verification, Medical Terminology, Attention to Detail, Communication Skills, Fast Paced Environment, Patient Interaction, Referral Management, Documentation, Team Collaboration, Problem Solving

Industry

Medical Practices

Description

Job Details Job Location: Austin, TX 78759 Position Type: Full Time Salary Range: $16.00 - $24.00 Hourly Job Category: Health Care ***MUST RESIDE IN TEXAS AND BE ABLE TO ATTEND ONBOARDING IN NORTHWEST AUSTIN FOR DAY ONE*** Reports to: Assistant Business Office Manager / Revenue Cycle Manager Department: Business Office Status: Full-Time / Non-exempt GENERAL JOB DESCRIPTION: Responsible for all insurance verifications, benefit documentation, referrals, preparing procedure estimates and authorization for assigned location(s)/doctor(s). ESSENTIAL FUNCTIONS: Correct and update Registration Information to ensure accuracy in claims filing as identified in the patient account Prepare estimates for all procedures, notify patients and collect prior to procedures for assigned doctor(s) Consults with the appropriate provider to obtain clearance that treatment regimen is considered medically necessary before initiating request to the insurance plan. Verifies eligibility and notifies appropriate parties if eligibility has termed. Processes referrals as needed, based upon insurance plan. Submits medical records, works with the provider on necessary documentation, if necessary, to obtain authorization. Notifies clinical staff, related physician and supervisor of any delays in obtaining authorization. Schedules Peer-to-Peer calls when necessary. Communicates any issues with authorization to team lead and appropriate surgery coordinator. Handle patient calls for assigned doctor(s) as necessary, responding within 24 hours. Issue appropriate paperwork for accounts requiring adjustments, patient refunds and corrections when identified. Obtain necessary referrals, document in Referral Management and attach referral in schedule/visit Receives questions from Office Manager for time of service collection issues the manager cannot resolve with the patient Work with RCM and Reception Manager to identify ways to increase efficiency in demographic entry Other duties as assigned. Qualifications QUALIFICATIONS Education: High School diploma Experience: Two year previous experience in a medical office setting Previous experience with insurance benefit verification Licensure: Special Skills: Knowledge of medical and insurance terminology Attention to detail Ability to effectively communicate both orally and written Ability to work in a fast paced environment Physical Demands: Must have adequate visual acuity to read, the ability to interpret and understand written material. Environmental Working Conditions: Continuously handle multiple tasks simultaneously and work as a part of a team. No conditions of chemicals/fumes/odors and dust/messiness.

Responsibilities

The role involves verifying insurance, preparing procedure estimates, and obtaining authorizations for medical treatments. It also includes consulting with providers and handling patient inquiries.