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Authorization & Eligibility Representative

Spine and Sport Physical Therapy

Authorization & Eligibility Representative

San Diego, CA
Full Time
Paid
  • Responsibilities

    Job Description

    We are seeking someone who can provide compassion and exceptional customer service while managing the administrative aspects of the Central Authorization Department, multi-line phones and patient scheduling. Experience with medical insurances is needed. Full time position available with medical benefits, paid time off, 401K and a unique opportunity for employee profit sharing.

    POSITION TITLE: Authorization & Eligibility Representative

    DEPARTMENT: Central Authorization

    REPORTS TO: Authorizations & Eligibility Manager

    ESSENTIAL DUTIES AND RESPONSIBILITIES

    • Process Physical and Occupational Therapy referrals
    • Process incoming faxes and referrals
    • Verify insurance eligibility
    • Contact payers to verify patient eligibility and benefits
    • Request prior authorizations from multiple insurance companies
    • Provide payers with additional information to help facilitate authorization process
    • Make outbound calls to insurance payers for status of authorization requests
    • Contact referral sources as needed to obtain additional information
    • Provide back office support to all clinics
    • Complete daily insurance task list from clinics
    • Receive and distribute inbound calls to different clinics
    • Utilize our EMR system, Raintree

    QUALIFICATIONS

    • Minimum 2 years of Customer Service
    • Strong communication skills to effectively communicate with patients and referring physician offices
    • Excellent customer service skills
    • Must be a team player
    • Ability to adapt, prioritize and meet deadlines
    • Positive energy and attitude ability to "smile over the phone"
    • Accurately an efficiently enter information into different portals & systems as needed
    • Handle multiple departmental tasks simultaneously
    • Ability to use phone and computer systems
    • Facilitate patient inquires in a timely manner
    • Working knowledge of PPO & HMO insurances

    EDUCATION

    • High School Diploma or GED Required
    • BA Degree preferred

    PHYSICAL DEMANDS

    • Requires prolonged sitting, frequent mobility, and some bending, stooping, stretching
    • Requires vision and hearing within normal range
    • Requires manual dexterity in the use of office machines such as telephone, copier, computers, and other equipment as necessary
    • Some lifting of up to 30 pounds