About The Role
The Kansas City Orthopedic Alliance is dedicated to providing an inclusive, diverse, welcoming, team-oriented job environment that affords our employees an opportunity to grow and excel in their positions. Our commitment is to each other and our patients. This allows us to deliver the gold standard of patient care, communication, treatment and outcomes at every step of the healthcare process. Customer service, empathy and logic will drive our decision-making and influence our culture of selflessness and charity. This team is greater than the sum of its parts, but each individual’s contribution will lead to the ultimate success of our company.
Essential Physical Demands:
Inability to meet one or more of these physical and/or mental requirements will not automatically disqualify a candidate, or employee from the position. Upon request for a reasonable accommodation, the Company may be able to adjust or excuse one or more of these requirements, depending on the requirement, the essential functions to which it relates, and the proposed accommodation.
- Must be able to sit constantly to perform job duties
- Stand and bend occasionally for the performance of job duties
- Constant usage of a headset may be required for completion of job tasks
- Pre-certification of procedures: MRI, CT, Bone Scans, Viscosupplementation, etc.
- Use of online Insurance or Product portals to obtain benefits and Pre-certifications (May be obtained via phone call as well)
- Initiate appeals or peer to peer discussions for denied authorizations
- Open line of communication with PCT’s, FDR to confirm Pre-certification is complete and ensure that information is sent to the appropriate scheduler to get the patient on the physician’s schedule
- Will assist/provide coverage/support for other team members as appropriate to ensure that the collective work of this team is performed in a timely, efficient, and customer-centric fashion.
- Knowledge of procedure authorization and its direct impact on the practices revenue cycle
- Understanding of payer medical policy guidelines and using those to manage authorizations effectively
- Medical Terminology, ICD-10 and CPT coding, medical insurance knowledge
- Excellent computer skills including EMR and Internet use
- Detail oriented with strong organizational skills
- Excellent customer service skills; Communicates clearly and effectively
- Ability to multitask and remain focused while managing a high volume, time sensitive workload
- Experience: 1-3 years of relevant experience and/or training preferred
- Education: High School Diploma or GED