Patient Access Representative I - Benefits / Authz

Job Description

Job Description

In this role you will :

Be responsible for accurately and efficiently verifying and documenting all new and existing insurance benefits to ensure that the correct co-pay is collected at the time of service, claims are filed to the correct mailing address, and referral requirements are entered so that the Authorization Representative may obtain referral if required

Key Responsibilities :

• Contacting insurance companies via phone or internet to obtain effective date of insurance coverage, type of coverage, co-pay or co-insurance information, coverage for x-rays and casting, PCP information if required, whether referral is required, and address for claims submission.
• Ensure all benefit information if properly documented in the system.
• Contact patient if information we have is not correct or we are unable to verify benefits for any reason, in order to obtain accurate information prior to patient’s scheduled appointment.
• Re-verify patient insurance benefits every 60 days.
• Properly document the need for referral and coordinate with the Authorization Representative to confirm if any authorization questions occur.
• Utilize insurance websites (Availity, Humana Military (Tricare), United Healthcare, etc.…) to obtain insurance benefits.
• Assure compliance with all company plans policies and procedures set forth by the Florida Orthopaedic Institute
• All other duties as assigned.

About You :

At FOI our goal is to provide our patients with world-class orthopedic care.

Our mission of providing the best care encompasses not only the care the physician provides, but all medical and administrative aspects of the patients encounter with Florida Orthopaedic Institute (FOI) as well. Every staff member plays a vital role in this mission. We take pride in receiving the Patriot Award from the Department of Defense for the support that we give to National Guard and Reserve members who are employed by FOI. We are committed to encouraging a culture of inclusion reflective of the communities we serve, and we provide equal opportunity to all. Florida Orthopaedic Institute conforms to the spirit as well as to the letter of all applicable laws and regulations.

What we offer :

Orthopaedic Solutions Management is a Drug Free Workplace

We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug-free workplace. All candidates will be required to undergo pre-employment drug screening and / or be subject to random drug testing in accordance with applicable laws and company policy.