What are the responsibilities and job description for the Pre-Authorization Specialist position at Premier Bone and Joint Centers?
Job Summary:
This job is NOT remote and is located in Laramie, WY. Perform insurance pre-certification duties for surgical procedures, MRI scans, and injections. Make payment arrangements for estimated patient responsibility for surgical procedures, MRI scans, and injections per policy; provide excellent patient services via telephone and in person.
Essential Duties and Responsibilities
Correct Insurance Company
- Obtain correct insurance company information such as Workers' Compensation vs. commercial insurance, including telephone number and policy numbers from system.
Pre-Certification/Pre-Authorization
- Contact insurance companies to obtain pre-certification for all outpatient surgical procedures, inpatient surgical procedures, short-stays, MRI and CT scans, and injections, if required by the insurance plan.
Insurance Benefits
- Obtain insurance benefit information and calculate pre-surgical payments for all surgical procedures performed at all locations and for all MRIs perfomed at Premier Bone and Joint Centers' locations.
Contact Patient
- Contact patients regarding estimated patient responsibility amounts for all surgical procedures, MRIs, and injections scheduled at all Premier Bone & Joint Centers' locations, review all outstanding balances with patients, and design payment arrangements if necessary.
Surgical Charts
- Assemble ASC surgical charts and deliver the charts to the front desk the day before the scheduled surgical procedure.
Pre-Payment Information
- Provide pre-payment information to the front desk staff.
Insurance Carrier Tools
- Use insurance carrier tools to estimate patient out-of-pocket costs.
Insurance Contractual Discounts
- Knowledge of insurance contractual discounts.
Insurance Provider Policy Knowledge
- Knowledge of insurance provider policies and procedures regarding patient claims.
Medical Terminology Knowledge
- Knowledge of medical terminology and basic human anatomy.
Requirements
Education:
- High School Diploma or Equivalent General Required
Experience:
1 Year - Business Office Type Experience - Preferred
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
- No weekends
Ability to commute/relocate:
- Laramie, WY 82070: Reliably commute or planning to relocate before starting work (Required)
Work Location: One location
Salary : $27,000 - $34,200
