Authorizations & Referral Coordinator
At OrthoArizona, we’re 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 a Authorization & Referral Coordinator with OrthoArizona, you’ll get to:
- Answers phone in prompt, courteous and helpful manner, screening, and routing calls as needed, creates phone note in the patient electronic medical record, and/or provides information to patients.
- Registers patients in EMR as applicable
- Confirms patient demographics and paperwork for accuracy, completions, and missing information
- Verifies insurance eligibility and benefits in accordance with patient insurance coverage for all patient office encounters and referral orders.
- Ensures proper clinical chart documentation present for all patient office encounters and for all Referral Orders
- Obtains 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 calculates any estimated patient out of pocket costs for services, communicates all out-of-pocket costs to patient and collects prior to services being rendered
- Documents the authorization status in proper manner in all applicable areas of EMR.
- Builds accurate Case Management in EMR and attach appropriate CM as indicated
- Notifies all applicable staff as to status/completion of above processes
- Courteously interacts 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 auth/referral status.
- Schedules patients for follow-up office visits or procedures, logs no-show appointments; assist in indexing all Document Management images as indicated.
- Maintains medical records in accordance with practice policies and procedures.
- All other duties as assigned.
Your experience should include:
- 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
- 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
- More than 3 years of direct experience and proficiency in authorizations, eligibility, and benefits in a medical office setting
- Bilingual is a plus.
What we'll Provide to you:
- Medical, 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