Authorization and Eligibility Representative

At OrthoArizona, we bring together a wide range of orthopedic surgeons, mid-level providers, physical and occupational therapists to serve all orthopedic and podiatry needs throughout the Valley. As one of Arizona’s largest privately owned and most comprehensive orthopedic practices, we have over 75 locally and nationally renowned providers across 30 locations, two ambulatory surgical centers, and in-house state-of-the-art MRI capabilities. We are committed to best-in-class patient care, pioneering research and technology, and rewarding and recognizing our employees.

About the role

• Verify insurance coverage for potential new patients, add-ons, and re-verify coverage for existing patients.
• Navigate multiple insurance portals or contact insurers by phone to obtain necessary benefits.
• Reconcile obtained information within the Practice Management System, EMR, and Phreesia to ensure successful claim processing.
• Obtain all referrals and authorizations for Physical Therapy patients as required.
• Act as a liaison between patients, healthcare providers, and insurance carriers to ensure proper measures are taken and information is collected.
• Enter authorization numbers and expiration dates into the Practice Management System, EMR, and Phreesia for proper claim processing.
• Update pertinent insurance notes in multiple EMR systems for corresponding departments to access.
• Maintain medical records in accordance with practice policies and procedures.
• Use state or federally regulated websites that may require personal login credentials.

Requirements

• High School diploma or GED.
• Minimum of 2 years of experience in healthcare administration or a related field.
• Excellent customer/patient service skills.
• Knowledge of medical terminology and insurance authorization processes.
• Working knowledge of health insurance plans, including reading plan requirements.
• Strong organizational, written, and verbal communication skills.
• Ability to work independently and as part of a team.
• Ability to meet metric deadlines and stay within goal expectations with little oversight.
• Ability to promote a favorable facility image with physicians, patients, insurance companies, and the general public.
• Ability to communicate effectively on the telephone and make decisions to solve problems.
• Working knowledge of computer programs and practice management software.
• Follow all Standard Operating Procedures.

Preferred Qualifications

• Experience with Centricity Software and Phreesia.

Benefits

• Robust paid time off package including sick time, holidays, and paid time off.
• Medical insurance with multiple plan options.
• Health Savings Account with company contributions.
• Dental and vision insurance.
• 401(k) retirement plan.
• Pet insurance.
• ID theft protection and legal assistance.