Description:

Excel Orthopaedic Specialists in Woburn is hiring. We are a busy Orthopedic practice looking to hire a Referral/Authorization Specialists to add to our expanding team. The Referral / Authorization Specialist is responsible for processing referrals and prior authorizations to ensure that patient visits and procedures are covered by various payers. Proactively reviews OT and PT therapy schedules to determine which patients need referral or prior authorizations Verifies patient eligibility (insurance, worker's comp, MVA) Prepares, processes and tracks referrals and prior authorizations through various payer systems, documents all in eCW per protocol Makes follow up calls to patients and payers (insurance company, workers comp, etc) Responds to questions and requests from leadership, providers, payers and patients Demonstrate professional communication and problem solving with providers and leadership, participate in process improvement and educate teams on updated guidelines and/or process. Completes other tasks as directed by management. Attends staff meetings and continuing education

Requirements:

High school diploma required, Bachelor's degree in related field preferred Minimum of two years' experience in medical and/or rehab billing and/or referrals/ prior auths Knowledge of medical terminology required Demonstrated ability to handle high volume of calls and claims in a fast paced environment Excellent verbal and written communication skills Strong computer skills including EMR and MS Office