Pre Authorization Specialist

MD West ONE offers the most comprehensive head-to-toe musculoskeletal and nervous system practice in the region. Our depth in orthopedic, pain, neurosurgery and spine specialized care allows our patients to be seen under ONE versatile, collaborative entity.

The Pre Authorization Specialist obtains surgery authorizations and patient insurance information, and prepares surgery pre-payments in a fast-paced neurosurgery and orthopedic clinic.

Hours: 7:00am-5:00pm Monday-Friday. (40 hours)

Primary Responsibilities:

• Obtain and verify benefit details (deductibles, coinsurance and out-of-pocket amounts) and insurance information for patients with upcoming surgeries.
• Obtain prior authorizations, pre-certifications, and pre-determinations for upcoming surgeries.
• Request conservative treatment records, as needed, for use in pre-service insurance reviews.
• Estimate surgery pre-payments, mail financial estimates to patients and process the pre-payment for patient prior to surgery.
• Assist with entering pain scales, as needed.
• Maintain ongoing communication for efficient clinic operations.
• Demonstrate regard for the dignity and respect of all patients, family members, medical staff, visitors and clinic employees.
• Maintain HIPAA compliance.
• Answer telephone in a courteous, helpful manner.
• Other duties, as assigned.

QUALIFICATIONS:

• High school diploma or equivalent, required.
• Knowledge of medical terminology, preferred.
• Experience in a neurosurgery or orthopedics setting, preferred.
• Experience with Cerner, preferred.

KNOWLEDGE, SKILLS AND ABILITIES:

• Ability to build strong relationships at all levels of the organization and provide exemplary customer service to patients.
• Ability to listen effectively, as well as strong communication skills.
• Must demonstrate professionalism at all times.
• Demonstrate strong judgment.
• Ability to work independently or as part of a team and meet deadlines.
• Maintain regular attendance.
• Must be able to tolerate intermittent physical activity, including sitting, standing, stooping, carrying, talking, seeing, bending, and handling equipment. Position will require full range of motion and may require lifting items weighing up to 30 lbs.
• Ability to reach with hands and arms to operate office equipment.

WORK CONDITIONS:

• This is a hybrid position requiring work within a healthcare clinic and work from a remote office setting. Job should not require contact with clinic staff or patients.

Please note that previous experience in a similar role or relevant certifications may be preferred but not required. We are looking for individuals who are passionate about making a positive impact in the lives of others.

If you are dedicated, compassionate, and committed to providing quality care, we encourage you to apply for this rewarding position.

MD West ONE provides equal employment opportunity to and will not discriminate against applicants or employees on the basis of race, color, religion, sex, age, disability, marital status, genetic information, or because of past, current, or future military obligations or status, or on any other basis protected under federal, state or local laws, regulations, or ordinances. This policy applies to all terms and conditions of employment, including, without limitation, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Job Type: Full-time

Benefits:

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

Work Location: Hybrid remote in Elkhorn, NE 68022