RCM Authorizations Representative

🔥 13 hours ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $21 - $32 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Spire Orthopedic Partners

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2021

🏥 Healthcare

🤝 B2B

🏢 Enterprise

Healthcare • B2B • Enterprise

Spire Orthopedic Partners is a forward-looking capital and management partner for leading orthopedic and spine surgeons, operating as a management services organization (MSO) that provides administrative infrastructure and strategic support. The company partners with high-growth orthopedic practices across the Northeastern United States (Connecticut, New York, Massachusetts, Rhode Island), enabling around 165 physicians and 1,800 employees across 40 locations to grow, specialize, and focus on patient care while Spire handles operations, practice integration, and business development.

📋 Description

• Review EHR task lists to determine authorization requirements for commercial surgery, physical therapy, MRI/CT scans, injections/VISCO, and DME/bone stimulators • Review orders and necessary dictations in the EHR • Keep authorization lists updated so requests are sent timely • Document correspondence and order updates as status becomes available • Notify providers, arrange Peer to Peer requests, and follow up on outcomes • Notify clinical and radiology staff of authorization requirement changes • Serve as direct contact for outsourced authorization companies and support contractual turnaround times • Communicate scheduling needs with the Director of Operations, Office Managers, and PCCs • Act as a resource and first-line response for procedural and workflow issues • Keep staff informed of procedure and workflow changes • Maintain the authorization team task list • Maintain a professional work atmosphere with patients, physicians, coworkers, and administration • Work directly with RCM and operational teams to support proper scheduling and patient care • Monitor team communication and decision-making • Create, update, and access confidential patient data in the EMR accurately and confidentially • Serve as the main contact for provider correspondence and patient issues • Prioritize and multitask

🎯 Requirements

• Minimum of one-year prior authorization experience required • Knowledge of orthopedic procedures helpful, but not essential • Excellent telephone etiquette • Good written and oral communication skills • Computer literacy preferred, including practice management software, EMR, Microsoft Word, and Excel • Detail-oriented and strong organizational skills preferred • High school diploma or equivalent • Familiar with Local Coverage Insurance Plans • No travel required

🏖️ Benefits

• Excellent growth and advancement opportunities • Dynamic environment • Access to a diverse network of practitioners • Broad infrastructure of tools and programs to enhance employee experience • Competitive Compensation • Generous PTO • Health, dental, and vision benefits • 401(k)

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