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 mid-level providers. Our subspecialty orthopedic teams offer advanced expertise in conditions of the bones, muscles, and joints. Providing multiple locations, extensive orthopedic services, and focusing on continuity of care are among the top priorities of EmergeOrtho.

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/

E mergeOrtho is committed to being the trusted leader in innovative, quality-focused comprehensive musculoskeletal care. With offices across North Carolina,t he Authorizations Specialist is responsible for procuring effective surgical authorization information for patient surgical services from appropriate insurance carriers.

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:

• Prior medical assistant 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
• Scan and drop MRI/Visco related documents
• Submit to insurance for benefits and coverage details
• Collect any patient financial obligations

Responsibilities include, but are not limited to:

• Make calls to insurance companies for necessary surgical authorization of services for patient appointments.
• Utilize online services from insurance companies to obtain surgical 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 surgical authorizations through resolution.
• Research, correct and re-file any denied or rejected surgical authorization to maximize reimbursement.
• Ensuring surgical authorizations are up to date, entering surgical authorizations into EHR, scanning and linking surgical authorizations to the patient’s chart.
• Extensive scheduling coordination with the surgery department, specialist and ancillary departments is needed.
• Contact patient insurance provider to obtain authorization and confirm eligibility status for the surgery and verify patient’s insurance coverage to include deductibles, out of pocket maximums, etc.
• Using information obtained from insurance provider, calculates patient’s payment amount to be paid to EmergeOrtho prior to surgery.
• Document all information obtained in the practice management system to adequately relay said information to all staff and/or third party software.
• Report rules, changes and other information affecting surgical authorizations to the Medical Records Supervisor.
• Print reports from the practice management system to facilitate surgical authorization for appointment services for previously scheduled patients and patients added on.
• Participate in educational and training opportunities to maintain current knowledge of payment policies Organize electronic patient records based on referral status.
• Fills in for other account representative positions as needed.
• Performs other duties as required and assigned by the Medical Records Supervisor.