Pre-Registration Coordinator

Description

Who we are:

Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Headquartered in Stamford, Connecticut, the Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts.

What You’ll Do

Supports practice revenue and patient satisfaction goals by processing and coordinating patient referrals and authorizations for specialty services. - utilizing skills of tact, compassion, confidentiality, and professionalism.

Accountabilities

• Facilitates timely reimbursement by obtaining complete and accurate information on referrals needed for claims submission.
• Supports patient satisfaction goals by responding referral questions in a prompt and courteous manner.
• Reduces claims rejection rate by gathering additional information necessary for referral input prior to patient appointment or claim submittal.
• Follows protocols for proper authorization and processing of all referrals, maintaining tracking system.
• Communicates with staff regarding any issues or any need of follow up regarding acquiring appropriate documentation for referrals.
• Communicates with the patient on a timely basis to ensure referrals are received and inputted for scheduled appointments.
• Completes all administrative functions associated with referral activities in a timely manner.
• Enters all hospital, outpatient, DME and other patient specialty health services authorizations into computer system according to policies and procedures.
• Contributes to team efforts by assisting other departments at the direction of her/his manager or team lead.
• Participate in educational and professional development activities consistent with business needs.
• Maintain strictest confidentiality of medical/company information, being knowledgeable and following all HIPAA Regulations
• Answers patient phone calls while practicing excellent customer skills.
• Verifies third party payer information and coverage; seeking appropriate authorization for services as applicable
• Complies with applicable governmental regulations such as HIPAA.
• Documents all activity as appropriate in the collection notes in the computer system.
• Understand the requirements of the callers and our practice and input information into our systems.
• Take electronic messages and convey information to respective medical care providers.
• Understand various aspects of medical insurance.
• Learning urgent call management techniques
• Provide physician or hospital referrals.
• Scheduling diagnostic tests / follow up appointments for patients.
• Contacting / interacting with appropriate facilities, such as hospitals, rehabilitation centers, assisted living facilities, etc. in regard to patient care.
• Other duties as assigned by managers and leads.
  
  

Qualifications

Who You Are:

• One-year medical office/billing experience is preferred.
• High School diploma or equivalent required
• HIPAA and other regulatory policies
• Insurance regulations, policies, and procedures
• Medical office procedures, policies, practices and medical terminology, telephone protocol and professional etiquette
• Electronic medical systems is a plus, including AthenaOne.
• Strong communication skills, verbal and written.
• Computer skills, being proficient with Windows based software.
• Strong problem-solving skills and ability to think quickly, professional and efficiently.
• Ability to represent our organization in a professional manner.
  
  

What We Offer

• Excellent growth and advancement opportunities
• Dynamic environment
• Access to a diverse network of practitioners
• Broad infrastructure of tools and programs to enhance the employee experience
• Competitive Compensation
• Generous PTO
• Benefits package: health, dental, vision, 401(k), etc.
  
  

We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”).