Healthcare Outcomes Performance Co. (HOPCo)
MRI Referral and Authorization Specialist
Healthcare Outcomes Performance Co. (HOPCo), Wellington, Florida, United States
MRI Referral and Authorization Specialist
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 musculoskeletal system. Our locations feature highly trained orthopedic surgeons and a team approach to care, offering on-site X‑ray, MRI, physical therapy, and aquatic therapy.
As the practice grows, we are seeking a Referral & Authorization Specialist to work 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, pre‑certification) 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 insurance eligibility accuracy.
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.
Completes chart‑prepping tasks daily to ensure a smooth check‑in process for the patient and clinic.
Researches information needed to complete the registration process, including obtaining information from providers, ancillary 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 form to PCPs and insurance companies promptly.
Reviews and notifies front‑office staff of outstanding patient balances.
Maintains satisfactory productivity rates and ensures timeliness of claims reimbursement while meeting work‑queue goals.
Responds to in‑house provider and support staff questions, requests, and concerns regarding referral status, care coordination, or follow‑up status.
Identifies and communicates trends and/or potential issues to the management team.
Indexes referrals to patient account for existing patients.
Creates new patient accounts for non‑established patients to index referrals.
Demonstrates 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 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.
401(k) plan with company match.
Employee Assistance Program available 24/7.
Paid time off and paid holidays.
No evenings or weekends.
Business hours Monday – Friday 8 a.m. – 5 p.m.
And more.
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As the practice grows, we are seeking a Referral & Authorization Specialist to work 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, pre‑certification) 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 insurance eligibility accuracy.
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.
Completes chart‑prepping tasks daily to ensure a smooth check‑in process for the patient and clinic.
Researches information needed to complete the registration process, including obtaining information from providers, ancillary 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 form to PCPs and insurance companies promptly.
Reviews and notifies front‑office staff of outstanding patient balances.
Maintains satisfactory productivity rates and ensures timeliness of claims reimbursement while meeting work‑queue goals.
Responds to in‑house provider and support staff questions, requests, and concerns regarding referral status, care coordination, or follow‑up status.
Identifies and communicates trends and/or potential issues to the management team.
Indexes referrals to patient account for existing patients.
Creates new patient accounts for non‑established patients to index referrals.
Demonstrates 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 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.
401(k) plan with company match.
Employee Assistance Program available 24/7.
Paid time off and paid holidays.
No evenings or weekends.
Business hours Monday – Friday 8 a.m. – 5 p.m.
And more.
#J-18808-Ljbffr