Authorizations / Billing Specialist

Job Description

Job Description

Monday - Friday 8 : 30 - 5 : 00PM On site

The Authorizations Specialist is responsible for Orthopedic and Physical therapy billing / AR, monitoring incoming patient orders and gathering information needed to complete the pre-authorization and scheduling of an order. The individual will evaluate portions to be paid by the customer and perform all insurance related assignments. The individual is responsible for completing all job related responsibilities in a timely and accurate manner.

Benefits

Medical insurance, Prescription drug coverage, Voluntary Dental insurance, Voluntary Vision Insurance, 401K with company match, Paid holidays

Culture

Advanced Orthopedics and Sports Medicine Institute was founded in 2007 with the merger of two of the areas longest tenured practices – Western Monmouth Orthopedic Associates and New Jersey Orthopedic Associates. For more than 25 years, each has been a leader in providing quality orthopedic and sports medicine care. Together as one, we’re even stronger and making a real difference in people’s lives.

The combined practice allows us to draw on our complementary strengths to deliver exceptional patient-centered, patient-focused care for a better overall patient experience.

Responsibilities

Obtains authorization for all diagnostic imaging, orthotics, EMG studies, & Hyaluronic Acid Injections directly or by submitting documentation to facility or vendor. May provide authorizations for other areas, as needed, as directed by manager.

Contact patients as necessary to advise on scheduling.

Obtain injection medication from pharmacy for all commercial insurances and physicians in practice.

Scrub, and submit all physical therapy claims timely along with all supporting documentation.

Copay allocation of physical therapy claims.

Submit PT authorization requests as backup as needed

Ensures that the verification of customers insurance benefits is completed and updated

Notifies customers of deductibles, authorization approvals and co-insurance due

Regularly calls insurance companies to follow up on patient status / claims

Explores other payment options with customers when needed

Keeps sensitive customer and company information confidential at all times

Contacts customers to obtain any outstanding information

Learn and understand all aspects of Revenue Cycle responsibilities and participate in a cross-training session.

Coordinates authorizations for customers with PIP / Workers compensation claims.

Provides administrative support to workers compensation dept.

Liaison to attorneys regarding customer status and claims.

Cross trained to support and perform all aspects of back office.

Cover other assignments when requested by management

Phone must be turned on / logged in daily and ready to receive all calls related to patient bills, whether from patients or insurance companies.

Responsible for timely completion of all new hire training, departmental training and yearly compliance training on an ongoing basis.

• Responsible for timely and accurate completion of timesheets / time records for hours work and payroll processing.
• Time records must be completed and approved by employee no later than close of business on last day of each pay period.
• Other relevant duties as assigned by management

Requirements

Authorized to work in the US without sponsorship

Minimum 1 year experience in a medical setting

Computer Literacy with Micrososft office programs ( Outlook, Excel, etc)

High school graduate

Equal Opportunity Employer

Advanced Orthopedics and Sports Medicine Institute provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Requisition #cmfpiefbuz8eb0jo5so08p9mn