Job description

Summary:

Pre-register patients for appointment by verifying insurance coverage; obtain authorization and pre-certify office and surgical services for patients with HMO, PPO, and Commercial insurance coverage daily by performing the following duties.

Essential Duties and Responsibilities include the following.:

1. Reports to work as scheduled each day.
2. To act in a manner that is indicative of team spirit and cooperation.
3. Works cooperatively as a team member and supports the Mission, Vision and Values of Southern California Orthopedic Institute.
4. Complies with SCOI Policy and Procedures.
5. Pre-verify benefits and eligibility for all HMO, PPO, and Commercial insurances for all new patients. Re-verify benefits and eligibility for all established patients as needed and at the beginning of every year.
6. Completes eligibility form in Details section of Centricity; updates patient demographics as needed including allocation sets; enters alert notes into the system when applicable.
7. Receives completed Surgery Check-list or Authorization request from physician for pre-certification and/or authorization.
8. Contacts insurance company by telephone or uses internet to verify patient coverage and obtain benefit information for requested service or procedure.
9. Contacts insurance company to pre-cert procedure as required.
10. Creates Case for each procedure or service provided; completes Pre-cert Surgery Verification form in Case Notes.
11. Computes surgery deposit amount required from patient; notifies patient of surgery deposit amount by letter or by phone prior to scheduled procedure. Notifies patient prior to pre-operative appointment when possible.
12. Responds to patients' questions regarding surgery deposit and insurance coverage.

Secondary Job Duties: Other duties as assigned.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Education:

• High school or equivalent (Preferred)

Work Location: One location

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