Authorizations Specialist

From the mountains to the coast, EmergeOrtho is North Carolina’s premier provider, recognized for offering world-class, comprehensive, and compassionate care serving patients with 45 locations in 21 counties. As the largest physician-owned orthopedic practice in the state and the 5 th in the country, EmergeOrtho’s medical team includes upwards of 100 highly trained orthopedic specialists and nearly as many advanced practice providers. Our subspecialty orthopedic teams offer advanced expertise in conditions of the bones, muscles, and joints. Providing multiple locations, extensive orthopedic services including therapy and focusing on continuity of care are among the top priorities of EmergeOrtho. Please visit https://emergeortho.com/careers/ for additional information

EmergeOrtho, P.A. complies with applicable civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We are committed to the core values of Quality, Innovation, Compassion, Community, Education, Integrity, Teamwork, Diversity, and Inclusion. https://emergeortho.com/non-discrimination-notice/

EmergeOrtho is committed to being the trusted leader in innovative, quality-focused comprehensive musculoskeletal care. With offices across North Carolina, the Authorization Specialist reviews insurance benefits and obtains preauthorization for surgeries or procedures. This is an in-office position.

Responsibilities include, but are not limited to:

• Make calls to insurance companies for necessary authorization of services for patient appointments.
• Utilize online services from insurance companies to obtain authorizations and/or gather information regarding patients’ coverage for services.
• Process all items for review in the practice management system and assigned to the department and/or third party software.
• Handle all calls and/or written inquiries regarding appointment service authorizations through resolution.
• Research, correct and re-file any denied or rejected authorization to maximize reimbursement.
• Ensure authorizations are up to date, entering authorizations into EHR, scanning and linking authorizations to the patient’s chart.
• Extensive scheduling coordination with specialist and ancillary departments is needed.
• Contact patient insurance provider to obtain authorization and confirm eligibility status and verify patient’s insurance coverage to include deductibles, out of pocket maximums, etc.
• Document all information obtained in the practice management system to adequately relay said information to all staff and/or third party software.

Educational Requirements:

• High school diploma or equivalent is required;
A minimum of 3 to 5 years of experience in a medical office environment is preferred

Qualifications and Experience

• Strong customer service skills
• Ability to positively interact with providers, staff, patients and their family members.
• Ability to work in a fast-paced environment
• Ability to prioritize and handle multiple tasks and demands
• Sound interpersonal skills
• Strong organizational skills
• Strong computer skills
• Obtain authorizations from various insurance companies
• Contact patients to schedule appointments for study/Injections and for results
• Complete MRI screening form with patients
• Document all appointments and times in EMR and Athena
• Submit to insurance for benefits and coverage details