Role Description
Are you passionate about serving patients in an inspiring work environment alongside talented people? Get moving with OCR! With over 50 years in business, we are the premier provider of orthopedic care in Colorado, Wyoming, and Nebraska. Our organization continues to grow and we are looking for individuals who share our mission.
The Authorization/Benefits Coordinator primarily manages all aspects of the surgical benefits process including:
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Verifying patient benefits
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Contacting patients regarding eligibility and payment
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Entering surgical charges and receipts
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Following up on aging receivables
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Resolving any issues related to this process
This position works closely with insurance coordinators to develop knowledge, communicate changes or adjustments, and resolve issues with patient accounts. This position will have options for remote work and has the potential to work out of other OCR locations.
Qualifications
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High school diploma or equivalent is required.
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Minimum 1 year experience in the insurance or medical industry or equivalent experience with collections in a business/accounting department.
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Knowledge of medical terminology preferred.
Requirements
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Determines patient out-of-pocket expenses using estimates provided by surgery authorization personnel and patient insurance plan.
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Notifies patients of determined expenses and establishes payment arrangements per guidelines and department protocols.
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Provides prompt support for check-in personnel regarding insurance eligibility issues.
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Maintains complete, accurate and up-to-date notes in patient account regarding surgical benefits and pre-authorizations.
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Responds to insurance companiesβ requests for information in a prompt and professional manner.
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Corrects errors in assigned accounts and communicates other account errors to the respective Insurance Coordinator.
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Identifies problem accounts on a timely basis and communicates them to supervisor for further action.
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Follows up on all denials, claim suspensions, and severe reductions in reimbursement promptly.
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Demonstrates consistent collection work by monitoring patient accounts for payment of surgical agreements.
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Routinely audits coding and demographical data on visit tickets to ensure the accuracy of claims.
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Acts as backup for surgery authorization personnel on an as needed basis.
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Communicates all concerns, risk management issues, breakdown in protocol and constructive criticisms to supervisor.
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Other duties as assigned.
Benefits
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Medical, Dental, & Vision coverage
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Life and AD&D Insurance
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Short- and Long-term disability coverage
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Retirement savings and profit-sharing plan participation
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Employee Assistance Program
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Paid Holidays & Paid Time Off
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Company-sponsored events
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Annual merit increases
*Benefit eligibility is dependent on employment status, and a waiting period may apply.