Benefits and Prior Authorization Coordinator

$37,440 - $37,440/Yr

Concord Orthopaedics - Concord, NH

Full-time

Concord, NH

Ambulatory Health Care Services

About the position

The Benefits and Prior Authorization Coordinator is responsible for obtaining insurance benefits and prior authorization for surgical and injection procedures. This role involves professional discussions regarding financial matters with patients, providers, family members, and insurers, ensuring compliance with HIPAA guidelines. The coordinator will generate reports, confirm insurance eligibility, and coordinate necessary referrals and authorizations to facilitate patient care.

Responsibilities

• Generate daily and weekly prior authorization reports each morning.
• Determine insurance benefits and prior authorization requirements.
• Confirm insurance eligibility and benefits on every scheduled surgical or injection procedure.
• Obtain, coordinate, and confirm all referral and prior authorizations for surgical cases.
• Obtain, coordinate, and confirm all referral and prior authorizations for ESI injection cases.
• Coordinate and monitor revisit appointments between injections, providing updated information to insurance companies as needed.
• Work directly with providers to clarify and obtain additional clinical or coding information, coordinating peer-to-peer meetings as needed.
• Provide information to workers' compensation adjusters as needed.
• Perform other duties as assigned.

Requirements

• High school diploma or equivalent.
• Prior medical insurance, referrals, and medical office experience required.
• Strong time management and organization skills.
• Attention to detail and documentation skills.
• Ability to analyze information and possess general math skills.
• Pleasant demeanor and professional appearance.
• Ability to work independently and as part of a team.
• Exceptional customer service skills and ability to maintain composure in fast-paced and stressful situations.
• Excellent communication, telephone, typing, and computer skills.

Benefits

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance