Pre-Authorization Specialist – Premier Bone and Joint Centers – Laramie, WY

Job Summary:

This job is NOT remote and is located in Laramie, WY. Perform insurance pre-certification duties for surgical procedures, MRI scans, and injections. Make payment arrangements for estimated patient responsibility for surgical procedures, MRI scans, and injections per policy; provide excellent patient services via telephone and in person.

Essential Duties and Responsibilities

Correct Insurance Company

  • Obtain correct insurance company information such as Workers’ Compensation vs. commercial insurance, including telephone number and policy numbers from system.

Pre-Certification/Pre-Authorization

  • Contact insurance companies to obtain pre-certification for all outpatient surgical procedures, inpatient surgical procedures, short-stays, MRI and CT scans, and injections, if required by the insurance plan.

Insurance Benefits

  • Obtain insurance benefit information and calculate pre-surgical payments for all surgical procedures performed at all locations and for all MRIs perfomed at Premier Bone and Joint Centers’ locations.

Contact Patient

  • Contact patients regarding estimated patient responsibility amounts for all surgical procedures, MRIs, and injections scheduled at all Premier Bone & Joint Centers’ locations, review all outstanding balances with patients, and design payment arrangements if necessary.

Surgical Charts

  • Assemble ASC surgical charts and deliver the charts to the front desk the day before the scheduled surgical procedure.

Pre-Payment Information

  • Provide pre-payment information to the front desk staff.

Insurance Carrier Tools

  • Use insurance carrier tools to estimate patient out-of-pocket costs.

Insurance Contractual Discounts

  • Knowledge of insurance contractual discounts.

Insurance Provider Policy Knowledge

  • Knowledge of insurance provider policies and procedures regarding patient claims.

Medical Terminology Knowledge

  • Knowledge of medical terminology and basic human anatomy.

Requirements

Education:

  • High School Diploma or Equivalent General Required

Experience:

1 Year – Business Office Type Experience – Preferred

Job Type: Full-time

Benefits:

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

Schedule:

  • 8 hour shift
  • Day shift
  • Monday to Friday
  • No weekends

Ability to commute/relocate:

  • Laramie, WY 82070: Reliably commute or planning to relocate before starting work (Required)

Experience:

  • Insurance verification: 1 year (Preferred)
  • Medical billing: 1 year (Preferred)

Work Location: One location

Source: Indeed.com
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