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About the Role

Obtains pre-authorizations/pre-certification per payer requirements for services rendered and ensures authorization information is documented in the appropriate system. Your knowledge of insurance carriers and specific plan details will make you a valuable resource to patients, providers, and coworkers!

Responsibilities

• Obtains pre-authorizations/pre-certification per payer requirements for services rendered and ensures authorization information is documented in the appropriately in the system.
• Verifies physician orders are accurate.
• Ability to understand and communicate insurance co-pays, deductibles, co-insurances, and out of pocket expenses for point of service collections.
• Communication is maintained with providers, clinical staff, and patient in relationship to authorization status.
• Works and assists with the billing department in researching and resolving rejected, incorrectly paid and denied claims as requested.
• Helps to maintain a professional atmosphere for patients, family members and staff.
• Remains current with insurance requirements for pre-authorization and provides education within the departments and clinics on changes.
• Keep management informed of changes in authorization process, insurance policies, billing requirements, rejection or denial codes as they pertain to claim processing and coding.

Requirements

• Knowledge of medical codes and medical terminology required.
• High school degree or equivalent.
• Knowledge of CPT, HCPCS, and ICD-10 codes highly preferred.
• Medical terminology required.
• Ability to prioritize and perform multiple tasks with many interruptions.
• EMR experience required; MEDENT preferred.
• Requires prolonged sitting and/or standing; primarily using phone and computer.
• Position requires manual and finger dexterity and hand-eye coordination.
• Involves standing, sitting, and walking.
• Team member will occasionally be asked to lift and carry items weighing up to 10 pounds; normal visual acuity and hearing are required.

Skills

• Medical terminology
• CPT codes
• HCPCS codes
• ICD-10 codes
• EMR experience
• MEDENT

Location

• Amherst, NY

Work Type

• Full Time

Education Level

• High school degree or equivalent

Salary/Compensations

• $19.80 - $35.64 Hourly

About the Company

• Excelsior Orthopaedics and Buffalo Surgery Center are committed to the full inclusion of all applicants.

Equal Opportunity

• All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information.