Insurance Specialist Job at Surgery Partners, Durham, NC

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  • Surgery Partners
  • Durham, NC

Job Description

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North Carolina Specialty Hospital (NCSH) is a private, physician-owned medical center that opened its doors in 1926. Its commitment to growth and continuous improvement has helped the hospital maintain a high ranking in both quality measures and patient satisfaction. North Carolina Specialty Hospital offers surgical specialties in orthopedics, ophthalmology, ear, nose, and throat, as well as sports medicine, oral, plastic, podiatry, general surgery, interventional radiology, pain management, reconstructive surgery, and more.

Why join North Carolina Specialty Hospital?

  • Award Winning Hospital for Special Surgery
  • 5 Star CMS rated facility for patient experience
  • Positive Work culture
  • Career growth opportunities
  • Comprehensive Medical, Dental, Vision Insurance, Life and Disability Insurance
  • Telemedicine/You have access to Physicians 24/7/365 through MDLIVE
  • Paid Time Off
  • 401k Employer Match
  • Tuition Assistance

JOB TITLE : Authorization & Health Information Specialist

General Summary Of Duties

Under the direction of the Admitting and Health Information manager, this position is responsible for verifying surgical authorizations, assisting with Performance Improvement projects, compiling statistical data, and insurance audits. In addition, the position will assist with other admission and reception duties as needed. Anticipate the needs of customers and work proactively to improve services. Work with others to improve customer satisfaction and participates in special projects as needed.

Essential Functions

  • Verifies surgical authorizations according to established policies and procedures
  • Compiling statistical Data and assisting with insurance audits
  • Assists with reception and admission needs as necessary.
  • Follows all applicable laws and regulations regarding the release of information and the maintenance of medical records, including those that relate to the age and legal status of the patient.
  • Prioritizes work assignments and accomplishes tasks accurately and in a timely manner.
  • Utilizes automated processes and clinical information systems appropriately and efficiently.
  • Utilizes concepts of age/developmental stages in interactions with patients and families.
  • Adheres to all Hospital Policies and Procedures, specifically Guidelines for Appropriate Conduct, Corporate Compliance, Diversity, and Confidentiality.
  • Identifies potential risks to patients: identifies risks to patients in order to reduce incidence of injury; identifies actions to eliminate, minimize or report risks; identifies procedures to follow in the event of an incident; reports processes for common problems, failures and user errors.
  • Demonstrates the spirit of the philosophy, mission, and values of the hospital through words and actions and implements them into departmental processes, programs, and the working environment.
  • Applies the principles and values of customer service and continuous quality improvement while performing day-to-day activities of the position.
  • Maintains and protects confidentiality regarding all aspects of patient care, personnel and strategic issues.
  • Adheres to Confidentiality Policy.
  • Maintains positive working relationships and fosters cooperative work environment.
  • Adheres to the hospital's "Guidelines for Appropriate Conduct" in the HR Manual.
  • Displays honesty and mutual respect when communicating with peers and other departments.
  • Follows through on problems that may compromise effective job performance by using appropriate chain of command.
  • Complies with National Patient Safety Goals.
  • Universal precautions and infection control guidelines, including hand washing guidelines followed at all times.
  • Performs other duties as required or assigned, which are reasonably within the scope of duties in this job classification
  • Ability to work independently to meet established deadlines
  • Ability to make sound reasonable decisions
  • Demonstrates respect for diverse backgrounds of all patients, families and co-workers.
  • Seeks guidance, direction and assistance when needed.

Education

  • High School or equivalent

Experience

  • Surgical authorization experience is required

Skills, Knowledge And Abilities

  • Effective communication skills; both orally and written.
  • Highly organized.
  • Computer skills needed.
  • Ability to work with others within a team to ensure quality patient care.
  • Strong problem-solving skills.
Seniority level
  • Seniority level
    Entry level
Employment type
  • Employment type
    Full-time
Job function
  • Job function
    Other
  • Industries
    Hospitals and Health Care

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Job Tags

Full time, Remote work,

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