Prior Authorization Specialist

Boston O&P • Full-time • $40k - $45k / year • 3w ago

OrthoPediatrics Specialty Bracing:

As a leader in specialized pediatric orthotics, we take great pride in having the industry's top clinicians, technicians, and administrative staff, led by an executive team dedicated to advancing the orthotics and prosthetics profession. We have recently joined forces with OrthoPediatrics as their Specialty Bracing division to help more KIDS!

Our Vision:

To be recognized as the premier provider of pediatric orthotic and prosthetic services and products in the United States.

Our team believes in respectful truth and transparency when interacting with patients, referral sources, and our own team members. We hold ourselves accountable for providing only the best products and services to our patients. Our team is engaged and committed to continuous improvement of our products, our patient care, and ourselves.

Position Description: Handle all functions related to Patient Billing including: verification of insurance, authorization submission, acquisition of all necessary claim documentation. Responsible for all actions relating to delinquent accounts, collections agencies and special adjustments.

Job Responsibilities:

Verify patient Insurance
Submit prior authorization, if needed
Collect all the information necessary to work with insurance claims and patient billing.
Research, administer and resolve any billing discrepancies. Ensure the resolution of any collection’s issues for self-pay balances.
Ensure patient demographic and insurance information is input correctly into the Athena billing system.
Answer patient questions regarding charges.
Understand Copays, Coinsurance, & Deductibles.
Follow Standard Billing procedure
Build proactive relationship with administrative assistants

Requirements:

Strong math and data entry skills.
Knowledge of insurance process, medical terminology and coding.
Knowledge/experience working with billing and payment cycles for medical accounts
Solid experience working with Medicare/Medicaid, private insurance, and insurance verification, authorization and reimbursement
Strong organizational, problem solving and analytical skills.
Proficiency with MS Office (Word, Excel), spreadsheets and medical billing software.

Education/Experience:

High School or Associate Degree; related experience and/or training.

Benefits Offered for Eligible Employees:

Medical Insurance
Dental Insurance
Vision Insurance
Long & Short-Term Disability
Life Insurance and AD&D
Retirement Savings Plan
Paid Time Off (PTO) & Holidays

Equal Opportunity Employer:

OPSB is proud in its commitment to creating a diverse workforce and providing equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, parental status, national origin, age, disability, citizenship status, genetic information or characteristics, marital status, status as a Vietnam era veteran, special disabled veteran, or other protected veteran in accordance with applicable federal, state and local laws, and any other characteristic protected by law.

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