Job description

Southeast Orthopedic Specialists began in 2001 with the mission to make industry-leading five-star orthopedic and spine care accessible to Northeast Florida. That mission has been driven by our ability to continually innovate and to offer the most advanced treatment options anywhere in the region. Our reach will continue to expand to meet the needs of all patients, present and future.

Celebrating recent and upcoming expansions, we are currently hiring Surgical Authorization Specialists for our Business Office in Jacksonville, FL! Listed below are specified benefits and compensation rates offered to Full-Time and/or PRN employees in this position:

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~ FULL TIME: Surgical Authorization Specialist - $15+/hour ~ (based on experience)

• Competitive Health & Welfare Benefits
• Monthly $43 stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan after 6 months of service with company match
• Employee Assistance Program that is available 24/7 to provide support
• Employee Appreciation Events
• Paid Holidays & Paid Time Off

** PRN AND PART-TIME EMPLOYEES ARE NOT ELIGIBLE FOR THE LISTED BENEFITS OTHER THAN, 401K AND 401K COMPANY MATCH **

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GENERAL STATEMENT OF DUTIES
As a team member of the Authorizations department, the specialist will be responsible for obtaining authorizations, verifying eligibility and coordination of benefits, and obtaining a cost estimate for surgical procedures. Customer service skills and the presentation of a professional image are essential for the position.

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ESSENTIAL FUNCTIONS

• Monitors the authorizations of upcoming surgical cases on the physician’s calendars ensuring authorizations for surgeries are obtained in a timely and accurate manor.
• Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans.
• Accurately completes surgical cost analysis form, documenting the required surgical cost estimation for collection prior to services.
• Verifies benefits on all surgical procedures.
• Document’s authorizations and progress of authorizations in the patient’s chart. Enters the authorization information within case management.
• Must be able to communicate effectively with physicians, patients, and co-workers and be capable of establishing good working relationships with both internal and external customers.
• Participate in providing ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases.
• Work with department manager to respond to and reduce complaints timely and professionally.
• Assist surgery schedulers with STAT authorizations.
• Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines.
• Assists in identifying opportunity for improvement within daily work flow process.
• Attends department meetings as required.

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EDUCATION

• High school diploma/GED or equivalent working knowledge preferred.

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EXPERIENCE

• Minimum of 2 years’ experience in healthcare field is required and previous experience in referrals/authorizations, front office, and/or charge posting is preferred.
• Excellent organizational skills and strong customer service orientation are required with strong background with computers and data entry.

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KNOWLEDGE

• Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers and other funding sources.
• Federal, state and HIPAA privacy regulations.
• Knowledge of computer applications.

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SKILLS

• Skill in effective organization and billing requirements and authorization processes.
• Skill in using computer programs and applications including Microsoft Excel, Microsoft Word and Outlook
• Skill in establishing good working relationships with both internal and external customers.

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ABILITIES

• Ability to multi task in a fast-paced environment. Must be detailed oriented with strong organizational skills.
• Ability to understand patient demographic information and determine insurance eligibility.
• Ability to work independently and demonstrate the ability to analyze data.
• Ability to communicate effectively and compassionately with patients, co-workers, management, and providers.

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ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment.

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PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching required.
• Manual dexterity using a calculator and computer keyboard

~ VISIT OUR WEBSITE FOR MORE INFORMATION - WWW.SE-ORTHO.COM ~

** This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve **

Job Type: Full-time

Pay: $15.00 - $16.50 per hour

Benefits:

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

Schedule:

• 8 hour shift
• Monday to Friday
• No weekends

Education:

• High school or equivalent (Required)

Experience:

• Insurance verification: 1 year (Required)
• Organizational skills: 1 year (Preferred)
• Microsoft Excel: 1 year (Preferred)
• Office experience: 1 year (Preferred)

Work Location: One location

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