Healthcare Outcomes Performance
MRI Referral and Authorization Specialist
Healthcare Outcomes Performance, Wellington, Florida, United States
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 offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy.
Referral & Authorization Specialist- Full time (M-F) Onsite
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, web-based 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 obtaining information from providers, ancillary services staff, and patients.
Fax referral form to providers that do not require any records to be sent. Be able to process 75-80 referrals daily. For primary specialty office visits, fax referral/authorization form to PCPs and insurance companies in a timely fashion.
Reviews and notifies front office staff of outstanding patient balances.
Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
Respond to In-house provider and support staff questions, requests, and concerns regarding the status of patient referrals, care coordination, or follow-up status.
Identifies and communicates trends and/or potential issues to the management team.
Index referrals to patient account for existing patients.
Create new patient accounts for non-established patients to index referrals.
The job holder must demonstrate current competencies for this position.
Education High school diploma/GED or equivalent working knowledge preferred.
Experience
Minimum one year of experience in a healthcare environment in a referral, front desk, or billing role.
Minimum one year of Athena experience preferred.
MRI authorization experience is a plus.
Minimum one year of experience in medical insurance authorizations required.
Benefits
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
Closed on major holidays
No evenings or weekends
Business hours Monday -Friday 8a - 5p
and more...
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
#J-18808-Ljbffr
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 offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy.
Referral & Authorization Specialist- Full time (M-F) Onsite
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, web-based 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 obtaining information from providers, ancillary services staff, and patients.
Fax referral form to providers that do not require any records to be sent. Be able to process 75-80 referrals daily. For primary specialty office visits, fax referral/authorization form to PCPs and insurance companies in a timely fashion.
Reviews and notifies front office staff of outstanding patient balances.
Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
Respond to In-house provider and support staff questions, requests, and concerns regarding the status of patient referrals, care coordination, or follow-up status.
Identifies and communicates trends and/or potential issues to the management team.
Index referrals to patient account for existing patients.
Create new patient accounts for non-established patients to index referrals.
The job holder must demonstrate current competencies for this position.
Education High school diploma/GED or equivalent working knowledge preferred.
Experience
Minimum one year of experience in a healthcare environment in a referral, front desk, or billing role.
Minimum one year of Athena experience preferred.
MRI authorization experience is a plus.
Minimum one year of experience in medical insurance authorizations required.
Benefits
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
Closed on major holidays
No evenings or weekends
Business hours Monday -Friday 8a - 5p
and more...
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
#J-18808-Ljbffr