OrthoLA
Pre-Certification / Authorization Specialist
OrthoLA, Thibodaux, Louisiana, United States, 70301
Pre-Certification / Authorization Specialist
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Pre-Certification / Authorization Specialist
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OrthoLA - Orthopaedic Sports Medicine, Joint & Hand Specialists . Job Summary:
The Insurance Authorization Specialist is responsible for obtaining patient insurance benefits, verifying eligibility, and ensuring pre-certification, authorization, and referral requirements are met prior to services for diagnostic imaging and surgical procedures. Responsibilities: Ensure accuracy of insurance information entered into patients medical record; update as necessary. Obtain/verify medical necessity for procedures. Verify insurance eligibility and benefits using automated systems, payer portals, or phone communication. Request, obtain, and track prior authorizations, precertifications, and preauthorizations. Obtain benefit details including deductibles, coinsurance, and out-of-pocket amounts. Prepare an estimate of patients out-of-pocket costs, communicate to the patient, and collect prepayment when necessary. Document all information accurately and timely in the patient's medical record. Provide ongoing communication regarding any changes or delays to payers, facilities, patients, and team members. Requirements: High school diploma or equivalent. One year of medical insurance authorization experience preferred. Knowledge of insurance provisions and health insurance is a plus. Skills: Ability to multitask in a fast-paced environment with high accuracy. Excellent customer service and patient-focused approach. Physical Requirements:
Prolonged sitting and working on a computer. Benefits:
Health, dental, vision, life insurance, 401(k) with company match, PTO, paid holidays, and employee perks. This is an in-person, full-time position based in Thibodaux, LA, with a typical Monday-Friday schedule. OrthoLA is an equal opportunity employer. #J-18808-Ljbffr
Join to apply for the
Pre-Certification / Authorization Specialist
role at
OrthoLA - Orthopaedic Sports Medicine, Joint & Hand Specialists . Job Summary:
The Insurance Authorization Specialist is responsible for obtaining patient insurance benefits, verifying eligibility, and ensuring pre-certification, authorization, and referral requirements are met prior to services for diagnostic imaging and surgical procedures. Responsibilities: Ensure accuracy of insurance information entered into patients medical record; update as necessary. Obtain/verify medical necessity for procedures. Verify insurance eligibility and benefits using automated systems, payer portals, or phone communication. Request, obtain, and track prior authorizations, precertifications, and preauthorizations. Obtain benefit details including deductibles, coinsurance, and out-of-pocket amounts. Prepare an estimate of patients out-of-pocket costs, communicate to the patient, and collect prepayment when necessary. Document all information accurately and timely in the patient's medical record. Provide ongoing communication regarding any changes or delays to payers, facilities, patients, and team members. Requirements: High school diploma or equivalent. One year of medical insurance authorization experience preferred. Knowledge of insurance provisions and health insurance is a plus. Skills: Ability to multitask in a fast-paced environment with high accuracy. Excellent customer service and patient-focused approach. Physical Requirements:
Prolonged sitting and working on a computer. Benefits:
Health, dental, vision, life insurance, 401(k) with company match, PTO, paid holidays, and employee perks. This is an in-person, full-time position based in Thibodaux, LA, with a typical Monday-Friday schedule. OrthoLA is an equal opportunity employer. #J-18808-Ljbffr