Coordinator - Pre-Authorization

Title: Coordinator Pre-AuthorizationLocation onsite:Hours: Monday Friday, 8-4Who we are:Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most patient care. Headquartered in Stamford, Connecticut, Spire Orthopedic Partners is a growing partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices in todays evolving healthcare landscape. The Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts.What youll do:Support practice revenue and patient satisfaction goals by processing and coordinating all patient referrals for specialty services.Responsibilities/Duties:Facilitates timely reimbursement by obtaining complete and accurate information on referrals needed for claims submission.Supports patient satisfaction goals by responding referral questions in a prompt and courteous manner.Follows protocols for proper authorization and processing of referrals, maintaining a tracking system to promote timely completion and / or follow up.Communicates with staff regarding any issues or any need of follow up regarding acquiring appropriate documentation for referrals.Communicates with the patient on a timely basis to ensure referrals are received and entered for scheduled appointments.Communicates with insurance companies and physician offices in order to obtain necessary insurance referral information.Completes all administrative functions associated with referral activities in a timely manner.Enters all referral, hospital, outpatient, DME and other patient specialty health services authorizations into computer system according to policies and procedures.Contributes to team efforts by assisting other departments at the direction of her/his manager or team lead.Participate in educational and professional development activities consistent with business needs.Maintain strictest confidentiality of medical/company information, being knowledgeable and following all HIPAA Regulations.Perform related work as required.Who you are:Qualifications:Familiarity with HIPAA, insurance regulations, policies, procedures and other regulatory policiesMedical office procedures, policies, practices and medical terminology, telephone protocol and professional etiquetteElectronic medical systems is a plus, including Athena/CentricityAbility to interpret, adapt and apply guidelines and proceduresDevelop and maintain effective and professional working relationships with patients, medical staff, coworkers and the public by displaying sympathy, tact and understandingMust be a team player with a positive attitude, work with a diverse population, demonstrating patience and professionalismPromotes teamwork through collaborationRepresents the clinic in a professional mannerAble to maintain strict confidentiality on all patient issuesWhat we offer:Excellent growth and advancement opportunitiesDynamic environmentAccess to a diverse network of practitionersBroad infrastructure of tools and programs to enhance the employee experienceCompetitive CompensationGenerous PTOBenefits package: health, dental, vision, 401(k), etc.We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as protected characteristics).IND6

Created: 2024-11-16