Healthcare Outcomes Performance Co. (HOPCo) logo
Healthcare Outcomes Performance Co. (HOPCo)

HOPCo is the leading provider of musculoskeletal value-based health outcomes, service line and practice management.

Procedure Authorization Specialist

Location

Arizona

Posted

11 days ago

Salary

0

Seniority

Mid Level

High School2 yrs expEnglish

Job Description

Procedure Authorization Specialist

Healthcare Outcomes Performance Co. (HOPCo)

• Monitors the authorizations of upcoming surgical cases on the physician’s calendars • Ensures authorizations for surgeries are obtained in a timely and accurate manner • Verifies patient demographic information and insurance eligibility including coordination of benefits • Updates and confirms necessary information to allow processing of claims to insurance plans • Accurately completes surgical cost analysis form • Verifies benefits on all surgical procedures • Documents authorizations and progress of authorizations in the patient’s chart • Communicates effectively with physicians, patients, and co-workers • Participates in providing ongoing training and education of staff • Works with department manager to respond to and reduce complaints

Job Requirements

  • High school diploma/GED or equivalent working knowledge preferred
  • A minimum of 2 years of experience in the healthcare field is required
  • Previous experience in referrals/authorizations, front office, and/or charge posting preferred
  • Excellent organizational skills and strong customer service orientation required
  • Strong background in computers and data entry
  • Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers, and other funding sources
  • Knowledge of computer applications

Benefits

  • Health insurance
  • Flexible work arrangements
  • Professional development opportunities

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Authorization Specialist

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Founded in 1998, AQUA Dermatology is the Southeast’s premier dermatology practice with over 110 locations throughout Florida, Georgia, and Alabama. Our established practices and experienced physicians offer patients the most quality outcomes and exceptional patience. From common rashes to skin cancer treatments, plastic surgery procedures to an array of vein treatments, no case is beyond our experience and expertise!

Role Description The Authorization Specialist will provide support for verifying current and accurate patient insurance information and to work with insurance companies to obtain authorization(s) for services. - Verify patient benefits and calculate out of pocket costs using multiple insurance resources. - Contact patients regarding out-of-pocket costs prior to patient services. - Obtain, review, and input insurance authorization and referrals prior to patient services. - Monitor and track patient authorizations. - Be proficient in the use of ICD-10 and CPT codes. - Verifies status of participating providers and insurance plans. - Support medical office team members. - Works closely with management team in business office to ensure all internal and external customer service issues are addressed. - Participates in educational activities and attends department team meetings. - Conducts oneself in accordance with company policies and procedures. - Performs other duties as required. Qualifications - Medical office experience: dermatology, plastic surgery, varicose vein, and/or radiation oncology preferred. - Knowledge of HIPAA regulations, insurance payers, ICD-10, CPT codes, and fee schedule reimbursement methodology. - Must be detail-oriented and a self-starter with the ability to work independently. - Possess excellent communication and organizational skills with the ability to multi-task, set priorities, and meet deadlines and departmental metrics. - Must be courteous with excellent customer service skills while maintaining strict confidentiality. - Possess high job accuracy, efficiency, and dependability. - Must have consistent, punctual, and reliable attendance. - Ability to establish effective working relationships with providers, staff, and the public. - Must have access to fast access internet. Requirements - High school graduate, GED or equivalent. - One year of medical office insurance and authorization experience. - Excellent computer, multi-tasking, phone, and electronic faxing skills. - Knowledge of Practice Software System/s. - Knowledge of Microsoft products. Benefits - Medical, Dental, and Vision are available after 30 days of hire. - Short-term disability and life insurance, and many ancillary options. - 10 days of PTO with an increase to 15 days upon completing 1st year. - 401 (k) available after 90 days of hire. - Excellent growth and advancement opportunities. - Discounts on services.

United States