Job Description

Authorization and Referral Coordinator
 
About OrthoArizona: 
At OrthoArizona, we are bringing the best together. Our organization was created to help serve ALL orthopedic and sports medicine needs throughout the Valley! We have a wide range of orthopedic surgeons and mid-level providers. Our mission is to provide excellent, compassionate care to our patients, their families, and visitors. 
  
As an Authorization and Referral Coordinator with OrthoArizona, you will get to: 
  • Answer phone in prompt, courteous and helpful manner, screening, and routing calls as needed. 
  • Creates phone notes in the patient's electronic medical record, and/or provides information to patients. 
  • Register patients in EMR as applicable. 
  • Confirm patient demographics and paperwork for accuracy, completion, and missing information. 
  • Verify insurance eligibility and benefits in accordance with patient insurance coverage for all patient office encounters and referral orders. 
  • Ensure proper clinical chart documentation is present for all patient office encounters and for all referral orders. 
  • Obtain prior authorization and/or referrals in accordance with patient insurance coverage for all patient office encounters and referral orders prior to services being rendered. 
  • Accurately calculate any estimated patient out of pocket costs for services, communicate all out-of-pocket costs to patient, and collect prior to services being rendered. 
  • Document the authorization status properly in all applicable areas of EMR. 
  • Build accurate Case Management in EMR and attach appropriate CM as indicated. 
  • Notify all applicable staff as to status/completion of above processes. 
  • Courteously interact with patients, family members, visitors, and members of the health care team; directs patient questions and/or concerns to appropriate department; keeps patients informed of authorization/referral status.  
  • Schedule patients for follow-up office visits or procedures, log no-show appointments; assist in indexing all document management images as indicated. 
  • Maintain medical records in accordance with practice policies and procedures. 
  • All other duties as assigned. 
Qualifications: 
  • Excellent customer / patient service. 
  • Knowledge of medical terminology. 
  • Working knowledge of computer programs. 
  • Excellent written and verbal communication skills. 
  • Understand/Perform training on practice management software. 
  • Ability to promote favorable facility image with physicians, patients, insurance companies, and general public. 
  • Ability to communicate effectively on the telephone. 
  • Ability to make decisions and solve problems. 
  • Working knowledge of health insurance plans including reading plan requirements. 
  • Follow all Standard Operating Procedures. 
Minimum Qualifications:
  • High School diploma or GED. 
  • 3 - 5 years medical front office, billing, or other administrative experience; and 
  • Proficiency in authorizations, eligibility, and benefits in a medical office setting. 
Preferred Qualifications:
  • More than 3 years of direct experience and proficiency in authorizations, eligibility, and benefits in a medical office setting. 
  • Bilingual is a plus. 
Full Time Benefits: 
  • Robust paid time off package including, sick time, holidays, & paid time off! 
  • Medical - including a plan with 100% employer coverage- a $585 monthly value. 
  • Health Savings account company contributions. 
  • Dental & Vision insurance. 
  • Company paid life insurance policy the option to purchase additional benefits to protect you from what life throws at you. 
  • 401(k) with a company contribution profit sharing! 
  • Pet insurance. 
  • ID Theft protection & Legal assistance. 

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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