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Surgery Authorization CoordinatorPrint
Job SummaryProliance Orthopaedics and Sports Medicine, a division of Proliance Surgeons, Inc., is currently seeking a qualified Surgery Authorization Coordinator.
Job DescriptionPosted: 10/06/2020
Our busy Orthopaedic practice is seeking a motivated self-directed hard working individual to manage all duties relating to Surgery Prior Authorization.
Proliance Surgeons is one of the largest surgical practices in the country, with over 425 providers including over 250 board-certified physicians providing treatment at more than 100 care centers in Washington State. Our range of specialties includes orthopedics, sports medicine, spine, ear nose & throat, general surgery, ophthalmology, obstetrics & gynecology, urology and more
- Effective communication skills
- Ability to work in high volume patient environment
- Strong attention to detail
- Working knowledge of medical terminology, abbreviations and anatomy
- Experience verifying insurance utilizing online portals
- 1 -year experience in referral coordination required
- Next Gen AND Epic experience preferred
Key Duties and Responsibilities
- Reviews and comprehends patient progress notes, lab reports, imaging reports, and plan of care. Identifies appropriate medical documentation that satisfies payer medical policy criteria
- Interacts professionally and effectively with clinicians, patients, and insurance companies
- Effectively coordinates Peer to Peer discussions between Clinicians and Insurance companies
- Follows-up with patients in the case of denied coverage of a radiology exam
- Provides superior customer service to all patients, works through patient-raised issues, and recommends appropriate solutions
- Verifies insurance eligibility and benefits, utilizing automated eligibility systems, payer portals, or telephone communication
- Maintains organized, detailed summaries of prior authorization requests to support post-claim denial workflows
Work Enviroment/Physical demands
- Some bending and stretching required
- Use of telephone required
- Manual dexterity required for use of the computer keyboard
- Being able to sit at a desk to perform job duties
Proliance Surgeons offers a generous benefits package including Medical/RX, Dental, Vision, 401k with profit sharing and more! Plus ALL of our employees enjoy the free perks of our employee purchasing program offering a variety of discounts on purchases made every day – including cell phone service!
Proliance Surgeons is proud to be an equal opportunity employer. We are committed to creating an inclusive environment, and we welcome and encourage people of all backgrounds, perspectives, experiences, and skills to apply.
All employment decisions at Proliance Surgeons are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.