AUTHORIZATION REPRESENTATIVE - CLEARWATER Job at Orthopaedic Associates of West Florida
Responsible for accurately and efficiently obtaining and documenting all referrals and authorizations
to ensure all patients are authorized for the physician, the date of service and all anticipated services Referrals and Authorizations are obtained by contacting physicians offices, insurance companies, and/or the patient.
Key Responsibilities:
- Coordinate with appropriate primary care physicians and/or insurance companies to obtain referrals for office visits prior to the patients scheduled appointment.
- Ensure all authorizations are properly documented in the system.
- Advise patients of any potential problems concerning obtaining authorization prior to the scheduled appointment.
- Coordinate with the Billing/Collections department to research and obtain authorizations on previously denied claims.
- Coordinate with the Benefit Verification Rep to confirm benefits when problems occur.
- Utilize the Internet (Emdeon, Availity, Humana Military (Tricare) and United Healthcare online) services to obtain referrals/authorizations.
- Assure compliance with all company plans, policies and procedures set forth by the Florida Orthopaedic Institute
- All other duties as assigned.
Qualifications
- High School Diploma
- 2 years experience in a medical clinic or health insurance
- athenaNet experience is a plus!
- Intermediate data entry skills
- Excellent customer service and communication skills.
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