Surgery Coordinator / Authorization Specialist
Position Summary
The Surgery Coordinator / Authorization Specialist is responsible for verifying eligibility, determining member benefit coverage. Identifies the amount the payer will be responsible for, identifies portions that are co-payments and deductibles. Sets up payment arrangements for the portion the patient is responsible for. Performs benefit investigations and prior authorizations for procedures/surgeries.
Essential Functions
Reasonable Accommodations Statement
To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.
Essential Functions Statement(s)
• Assures surgical patient accounts are maintained in a standardized order and are ready for scheduled office procedures.
• Verifies patient insurance and plan eligibility, where appropriate.
• Verifies benefits for procedure and surgery patients.
• Obtains prior authorizations for all surgical procedures.
• Completes written financial treatment plan and provides to patient.
• Follows up with patient to collect out of pocket balances – 3 days prior to procedure.
• Evaluates patient financial status and establishes a payment plan, if necessary.
• Makes “off bill” comments in each account in the practice management system.
• Maintains up to date fee schedules for the practice and insurance carriers.
• Investigates billing issues and works to formulate a solution.
• Obtains signed authorization to release patient financial information where appropriate.
• Maintains personal reference book on insurance companies and coverage.
• Issues proper receipts and maintains balanced drawer.
• Maintaining patient confidentiality.
• Ability to attend required meetings.
• Demonstrate flexibility in job assignment.
• Perform additional duties as assigned.
Position Qualifications
Competency Statement(s)
• Active Listening - Ability to actively attend to, convey, and understand the comments and questions of others.
• Accuracy - Ability to perform work accurately and thoroughly.
• Autonomy - Ability to work independently with minimal supervision.
• Communication, Oral - Ability to communicate effectively with others using the spoken word.
• Communication, Written - Ability to communicate in writing clearly and concisely.
• Customer Oriented - Ability to take care of the customers’ needs while following company procedures.
• Decision Making - Ability to make critical decisions while following company procedures.
• Detail Oriented - Ability to pay attention to the minute details of a project or task.
• Energetic - Ability to work at a sustained pace and produce quality work.
• Empathetic - Ability to appreciate and be sensitive to the feelings of others.
• Honesty / Integrity - Ability to be truthful and be seen as credible in the workplace.
• Organized - Possessing the trait of being organized or following a systematic method of performing a task.
• Reliability - The trait of being dependable and trustworthy.
• Working Under Pressure - Ability to complete assigned tasks under stressful situations.
Skills & Abilities
Education: High School or Equivalent
Experience: Minimum 1-year medical office experience. Working knowledge of medical insurance verification. Working knowledge of medical management software.
Computer Skills: Ability to efficiently operate computers and research, as needed. Comfortable with Microsoft Office
Certifications & Licenses: N/A
Other Requirements: Must have familiarity of insurance documents, must possess the ability to thoroughly understand and explain financial information as well as insurance information.
PHYSICAL DEMANDS
N (Not Applicable)
Activity is not applicable to this position.
O (Occasionally)
Position requires this activity up to 33% of the time (0 - 2.5+ hrs/day)
F (Frequently)
Position requires this activity from 33% - 66% of the time (2.5 - 5.5+ hrs/day)
C (Constantly)
Position requires this activity more than 66% of the time (5.5+ hrs/day)
Job Type: Full-time
Pay: $17.00 - $18.00 per hour
Expected hours: 40 per week
Benefits:
• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Uniform allowance
Ability to Commute:
• Lynchburg, VA 24502 (Required)
Work Location: In person
Technology, Information and Internet
Health Care Provider
Full-time