Eligibility and Benefits Specialist

About the role

At OrthoArizona, we are bringing the best together. Our organization was created to help serve ALL orthopedic and podiatry needs throughout the Valley! We have a wide range of orthopedic surgeons and mid-level providers including physical and occupational therapists. Today we are one of Arizona’s largest privately owned and most comprehensive orthopedic practices with more than 75 locally and nationally renowned providers across 30 locations, in addition to 2 ambulatory surgical centers and in-house state-of-the-art MRI capabilities. As an Eligibility & Benefits Specialist with OrthoArizona, you will get to:

• Verify insurance coverage for potential new patients and re-verify insurance coverage for existing patients.
• Navigate through multiple insurance portals or by phone to obtain necessary insurance benefits.
• Reconcile obtained information within EMR to ensure successful claim processing.
• Responsible for obtaining all referrals and authorizations for office visits, as required.
• Act as a liaison between patients, healthcare providers, and insurance carriers to ensure all proper measures are taken and information is collected.
• Enter any authorization numbers and expiration dates into the EMR for proper claim processing.
• Maintain medical records in accordance with practice policies and procedures.
• Use state or federally regulated websites may require personal login credentials.

Qualifications

• Excellent customer/patient service.
• Must be able to drive to location for in-person training period for first 90 days and as needed after.
• Knowledge of medical terminology.
• Working knowledge of computer programs.
• Excellent written and verbal communication skills.
• Understand/perform training on practice management software.
• Able to promote favorable facility image with physicians, patients, insurance companies, and general public.
• Able to communicate effectively on the telephone.
• Able to make decisions and solve problems.
• Working knowledge of health insurance plans including reading plan requirements.
• Follow all Standard Operating Procedures.
• High school diploma or GED.
• Minimum of 2 years of experience in healthcare administration or related field.
• Strong organizational and communication skills.
• Able to work independently and as part of a team.
• Knowledge of medical terminology and insurance authorization processes.

Full Time Benefits

• Robust paid time off package including, sick time, holidays, & paid time off!
• Medical with multiple different plan options.
• Health Savings account + company contributions.
• Dental & Vision insurance.
• 401(k).
• Pet Discount Plan.
• ID Theft protection & Legal assistance.