Front Office Authorization Specialist at GI Alliance – Phoenix, Arizona

Front Office Authorization Specialist
Job DetailsJob Location: ROCA CyberKnife Rad Onc - Phoenix, AZ 85028
Position Type: Full Time
Job Shift: Day
Description

Description

Position Summary: This hybrid role is responsible for scheduling new patient appointments, obtaining and verifying patient demographics and insurance information, coordinating all insurance authorizations and referrals, providing financial counseling, and supporting front-office operations. The position ensures a seamless patient experience from initial scheduling through treatment by managing insurance verification, prior authorizations, financial responsibility discussions, and related administrative tasks. Previous experience working with medical insurance is required, along with a compassionate approach to patient service.
Job Scope: Under general supervision, the role educates patients on insurance coverage and benefits, assesses financial ability, and may guide patients toward assistance programs. The specialist supports and adheres to the organization’s Compliance Program, including the Code of Ethics and Business Standards, while performing front-office duties such as patient check-in assistance, data entry, phone coverage, and general front-office support.
Essential Duties and Responsibilities: The essential functions include, but are not limited to, the following:

Schedules all new patient appointments for all physicians and follows up on hospital discharge appointments as directed by individual physicians.

Obtains complete new patient demographic and insurance information, inputs data into the computer system, and verifies insurance eligibility.

Responsible for acquiring, documenting, and obtaining all prior authorizations, referrals, and approval codes (from Clinical Reviewer when required) prior to the first visit and each subsequent treatment.

Contacts insurance companies or primary care physicians to secure authorizations/referrals; scans all documentation into the patient’s EMR.

Requests pertinent medical records from referring physicians and obtains hospital records for follow-up appointments.

Educates patients on insurance coverage, benefits, co-pays, deductibles, and out-of-pocket expenses prior to treatment.

Assesses patients’ ability to meet financial obligations, discusses payment arrangements, and completes Patient Cost Estimate forms based on diagnosis, coverage, and available assistance.

Completes appropriate reimbursement and liability forms for patient review and signature; forwards documents to the billing office.

Reviews patient account balances and notifies the front desk of patients who need to meet with financial counseling.

Ensures patient co-pay amounts are correctly entered into the system so the front desk can collect appropriately.

At each patient visit, verifies and updates demographics and insurance information per Standard Operating Procedures (SOPs).

Verifies patient eligibility at the first of every month for patients under active treatment and verifies insurance daily for follow-up patients; immediately notifies Billing of any changes.

Mails new patient forms or directs patients to complete them via the practice website.

Assists with phone coverage, patient check-in, data entry, and cross-coverage for other front-office staff.

Assists with training and supporting new staff.

Stays current on available financial aid programs, develops professional relationships with providers, and networks to identify additional resources.

Maintains updated manuals, logs, forms, and documentation.

Adheres to all confidentiality, state, federal, and HIPAA laws and guidelines regarding patient records.

Performs additional duties as requested or assigned by management.

Qualifications

Qualifications

Qualification/Requirements:

Ability to apply common-sense understanding to carry out detailed but uninvolved written or oral instructions.

Ability to deal with problems involving occasional, last-minute changes in generally standardized situations.

Previous experience working with medical insurance is required.

Compassionate and service-oriented approach to patient interactions.

Education/Training/Experience:

High school diploma or GED

Six months of related experience and/or training

Knowledge of EMR systems, medical terminology, ICD-10, and CPT codes is a plus

Physical Demands and Work Environment The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.
While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers to handle, feel objects, tools, or controls. The employee is occasionally required to stand, walk, sit, reach with hands and arms, climb or balance, and stoop, kneel, crouch, or crawl.
The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision, and the ability to adjust focus.
The noise level in the work environment is usually moderate.
This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments.
All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities.
This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.