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Insurance Authorization Specialist I | Days, Full Time in Indianapolis, IN at OrthoIndy

Date Posted: 4/5/2018

Job Snapshot

Job Description

Facility: OrthoIndy Northwest, Indianapolis, IN 
Department: Support Services, Telecom
Shift Details: Days, Full Time, Monday - Friday

At OrthoIndy everything we do is about creating a caring, connected and committed workforce that directly improves the quality of life for our employees and customers.

Be a part of something great!

Position Summary:

The Insurance Authorization Specialist I verifies and obtains insurance authorization and referrals prior to patient services and procedures. The Specialist is responsible for providing accurate and complete data input for precertification requests and for providing excellent customer service. The Specialist notifies the appropriate departments if insurance information and obtains and inputs corrected insurance information as needed.

Essential Duties:

  1. Verifies active insurance status and network information for each patient. Submits required information to insurance companies for pre-certification and authorization. Annotates steps completed on surgery orders in electronic medical record. Confirms receipt of all necessary preauthorization documents prior to procedures. Takes necessary steps to correct or cancel procedure if preauthorization information is missing or incorrect. Schedules test and clinic appointments as necessary.
  2. Documents precertification numbers and information in EMR and practice management program. Saves all precertification documents in practice management program for future reference.
  3. Serves as a point of contact for assigned Physicians and employees. Maintains rapport with Physicians, private staff, and coworkers to ensure excellent communication and satisfaction. Handles phone calls, tasking, and messages in the electronic medical record, related to the medical procedure.
  4. Checks insurance payment policy for scheduled procedure to ensure patient is aware of coverage limitations.
  5. Pre-operatively notifies ordering surgeon if insurance authorization does not include all CPT codes submitted. Takes appropriate steps to verify ordering surgeon received notification.
  6. Develops and supports effective Communication with other employees, professional support staff, customers, patients, families, and providers to ensure patient satisfaction.
  7. Support departmental and corporate strategic plans and ensure successful implementation.
  8. Support company and department quality assurance initiatives and goals.

Technology Used:

ADP, Allscripts, Halogen, Incident reporting, Microsoft Office, Moxee

Job Requirements

Requirements:

  • High School Diploma or GED required; Specialty Training Beyond High School preferred
  • 2-4 years of medical office/ insurance authorization experience required; 4-6 years of experience preferred

OrthoIndy is an Equal Opportunity Employer