Premier Orthopaedics
Referral and Authorization Coordinator
Premier Orthopaedics, Folsom, Pennsylvania, United States
Overview
Referral and Authorization Coordinator
role at
Premier Orthopaedics
in Folsom, PA.
Premier Orthopaedics
is looking for a
Referral and Authorization Coordinator
to work at our Folsom, PA office.
About Us Premier is a leading orthopedic practice committed to diagnosing and treating a wide range of orthopedic injuries and conditions. We operate in over 50 locations and have more than 55 physicians dedicated to providing exceptional care across the Greater Philadelphia area. With a team of nearly 1,000 employees, we thrive in a supportive environment that prioritizes collaboration and patient satisfaction.
What We Offer
Comprehensive Benefits: Medical, vision, and dental plans, 100% employer-paid life insurance, and a generous 401(k) match.
Work-Life Balance: Generous paid sick and vacation time, plus 7 paid holidays each year.
Flexible Work Hours: Morning or evening work schedule that supports your lifestyle.
Career Growth: Opportunities for professional development and advancement.
Employee Rewards: Participation in the employee referral reward program.
Essential Functions
Verifies and updates patient registration information in the practice management system.
Obtains benefit verification and necessary authorizations (referrals, precertification) before patient arrival for all ambulatory visits, procedures, injections, and radiology services.
Uses online verification systems and reviews real-time eligibility responses to ensure accuracy of insurance eligibility.
Creates appropriate referrals to attach to pending visits.
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Completes chart prepping tasks daily to ensure a smooth check-in process for the patient and clinic.
Researches all information needed to complete the registration process, including information from providers, ancillary services staff, and patients.
Fax referral forms to providers that do not require records to be sent. Process 75-80 referrals daily. For primary specialty office visits, fax referral/authorization forms to PCPs and insurance companies in a timely fashion.
Review and notify front office staff of outstanding patient balances.
Maintain satisfactory productivity rates and ensure timeliness of claims reimbursement while meeting work queue goals.
Respond to in-house provider and support staff questions and concerns regarding status of referrals, care coordination, or follow-up status.
Identify and communicate trends or potential issues to the management team.
Index referrals to patient accounts for existing patients.
Create new patient accounts for non-established patients to index referrals.
Education
High school diploma/GED or equivalent working knowledge preferred.
Experience
Minimum two to three years of experience in a healthcare environment in a referral, front desk, or billing role.
Effective communication with physicians, patients, and the public; ability to establish good working relationships with internal and external customers.
Working knowledge of Allscripts Practice Management and Allscripts EMR is a plus.
Requirements
Healthcare experience with managed care insurances, requesting referrals, authorizations for insurances, and verifying insurance benefits.
In-depth knowledge of insurance plan requirements for Medicaid and commercial plans.
Knowledge
Working knowledge of eligibility verification and prior authorizations for payment from various HMOs, PPOs, commercial payers, and other funding sources.
Knowledge of government provisions and billing guidelines including Coordination of Benefits.
Advanced computer knowledge, including Windows-based programs.
Skills
Skilled in defusing difficult situations and consistently pleasant and helpful.
Proficient with computer programs and applications.
Ability to establish good working relationships with internal and external customers.
Abilities
Ability to multi-task in a fast-paced environment.
Detail-oriented with strong organizational skills.
Ability to understand patient demographic information and determine insurance eligibility.
Typing speed of at least 45 wpm.
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Medical Practices
#J-18808-Ljbffr
role at
Premier Orthopaedics
in Folsom, PA.
Premier Orthopaedics
is looking for a
Referral and Authorization Coordinator
to work at our Folsom, PA office.
About Us Premier is a leading orthopedic practice committed to diagnosing and treating a wide range of orthopedic injuries and conditions. We operate in over 50 locations and have more than 55 physicians dedicated to providing exceptional care across the Greater Philadelphia area. With a team of nearly 1,000 employees, we thrive in a supportive environment that prioritizes collaboration and patient satisfaction.
What We Offer
Comprehensive Benefits: Medical, vision, and dental plans, 100% employer-paid life insurance, and a generous 401(k) match.
Work-Life Balance: Generous paid sick and vacation time, plus 7 paid holidays each year.
Flexible Work Hours: Morning or evening work schedule that supports your lifestyle.
Career Growth: Opportunities for professional development and advancement.
Employee Rewards: Participation in the employee referral reward program.
Essential Functions
Verifies and updates patient registration information in the practice management system.
Obtains benefit verification and necessary authorizations (referrals, precertification) before patient arrival for all ambulatory visits, procedures, injections, and radiology services.
Uses online verification systems and reviews real-time eligibility responses to ensure accuracy of insurance eligibility.
Creates appropriate referrals to attach to pending visits.
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Completes chart prepping tasks daily to ensure a smooth check-in process for the patient and clinic.
Researches all information needed to complete the registration process, including information from providers, ancillary services staff, and patients.
Fax referral forms to providers that do not require records to be sent. Process 75-80 referrals daily. For primary specialty office visits, fax referral/authorization forms to PCPs and insurance companies in a timely fashion.
Review and notify front office staff of outstanding patient balances.
Maintain satisfactory productivity rates and ensure timeliness of claims reimbursement while meeting work queue goals.
Respond to in-house provider and support staff questions and concerns regarding status of referrals, care coordination, or follow-up status.
Identify and communicate trends or potential issues to the management team.
Index referrals to patient accounts for existing patients.
Create new patient accounts for non-established patients to index referrals.
Education
High school diploma/GED or equivalent working knowledge preferred.
Experience
Minimum two to three years of experience in a healthcare environment in a referral, front desk, or billing role.
Effective communication with physicians, patients, and the public; ability to establish good working relationships with internal and external customers.
Working knowledge of Allscripts Practice Management and Allscripts EMR is a plus.
Requirements
Healthcare experience with managed care insurances, requesting referrals, authorizations for insurances, and verifying insurance benefits.
In-depth knowledge of insurance plan requirements for Medicaid and commercial plans.
Knowledge
Working knowledge of eligibility verification and prior authorizations for payment from various HMOs, PPOs, commercial payers, and other funding sources.
Knowledge of government provisions and billing guidelines including Coordination of Benefits.
Advanced computer knowledge, including Windows-based programs.
Skills
Skilled in defusing difficult situations and consistently pleasant and helpful.
Proficient with computer programs and applications.
Ability to establish good working relationships with internal and external customers.
Abilities
Ability to multi-task in a fast-paced environment.
Detail-oriented with strong organizational skills.
Ability to understand patient demographic information and determine insurance eligibility.
Typing speed of at least 45 wpm.
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Medical Practices
#J-18808-Ljbffr