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SalaryIn this role you will:
The Patient Access Representative II will be responsible for Scheduling and Benefits or Authorization. Scheduling/Benefits staff will be responsible for the coordination of scheduling and insurance verification by identifying insurance plans and benefits that are quickly identifiable through Athena at time of scheduling and documenting appropriately to assist the benefit by identifying insurance plans and benefits that are quickly identifiable at time of scheduling and documenting appropriately. Scheduling/Benefits Rep are responsible for accurately and professionally scheduling patients for FOI physicians according to patient need and physician protocol in a call center environment. Must obtain all information related to the appointment to include patient demographics, verifying, and documenting all new and existing insurance benefits to start the benefit and authorization process as well as method of referral.
Authorization Rep will be responsible for accurately and efficiently obtaining and documenting all referrals and authorizations for physician clinic visits by contacting physician’s offices, insurance companies and/or patient. is responsible for accurately and professionally scheduling patients for FOI physicians according to patient need and physician protocol in a call center environment. Must obtain all information related to the appointment to include patient demographics, verifying, and documenting all new and existing insurance benefits to start the benefit and authorization process as well as method of referral
Key Responsibilities:
Scheduling/Benefits Rep:
- Register all new patient in the computer system by obtaining patient demographics and insurance information and source of referral.
- Schedule appointments according to patient need and physician and authorization protocols.
- Verify benefits through electronic eligibility system to confirm effective date of insurance coverage, PCP Information, whether referral is required, co-pay or co-insurance information to ensure patient responsibility is collected at time of service.
- All obtainable benefit information at time of scheduling should be properly documented in the system so that any visits that need further financial clearance can be easily passed off the Financial Clearance Team.
- Update all information from prior visit if needed.
Authorization Rep:
- Coordinate with appropriate primary care physicians and/or insurance companies to obtain referrals for office visits prior to the patient’s scheduled appointment.
- Ensure all authorizations are properly documented in the system.
- Advise patients of any potential problems concerning obtaining authorization prior to the scheduled appointment.
- Coordinate with the Billing/Collections department to research and obtain authorizations on previously denied claims.
- Coordinate with the Benefit Verification Rep to confirm benefits when problems occur.
- Utilize insurance websites (Availity, Humana Military (Tricare), United Healthcare, etc.) to obtain referrals/authorizations.
Both Positions:
- Assure compliance with all company plans policies and procedures set forth by the Florida Orthopaedic Institute
- All other duties as assigned.
About You:
- Candidate must be a high school graduate.
- 2 or more years of experience in a Healthcare environment with registration/scheduling benefit/authorization background preferred.
- Must be detailed oriented.
- Excellent customer service and communication skills.
- Able to multi-task and handle high call volumes.
- Must have a working knowledge of Windows based computer environment and typing skills.
At FOI our goal is to provide our patients with world-class orthopedic care.
Our mission of providing the best care encompasses not only the care the physician provides, but all medical and administrative aspects of the patients encounter with Florida Orthopaedic Institute (FOI) as well. Every staff member plays a vital role in this mission. We take pride in receiving the Patriot Award from the Department of Defense for the support that we give to National Guard and Reserve members who are employed by FOI. We are committed to encouraging a culture of inclusion reflective of the communities we serve, and we provide equal opportunity to all. Florida Orthopaedic Institute conforms to the spirit as well as to the letter of all applicable laws and regulations.
What we offer:
- Full time opportunities available, with room for career growth and advancement.
- Excellent job security and stability, to promote an optimal work life balance.
- Be part of this dynamic and growing high level Patient Access team!
