Verify patient eligibility, benefits, coverage limitations, deductibles, co-insurance, and out-of-pocket responsibilities prior to date of service.
Obtain and validate prior authorizations and referrals in compliance with payer requirements.
Identify and resolve coverage discrepancies prior to surgery to prevent denials.
Communicate estimated patient financial responsibility clearly and professionally.
Accurately document all verification and authorization details in the practice management system.
Manage assigned A/R buckets and maintain productivity standards.
Follow up on unpaid, rejected, or denied claims in a timely manner.
Submit appeals with appropriate documentation to resolve denials and underpayments.
Review EOBs for accuracy and identify payment variances.
Monitor timely filing limits and prioritize high-dollar accounts.
Identify denial trends and escalate systemic payer issues to leadership.
Benefits:
Equal Employment Opportunity & Work Force Diversity
Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.
Surgery Partners is a leading operator of surgical facilities and ancillary services with more than 180 locations nationwide. We provide exceptional integrated healthcare experiences between our providers and patients.
Our diverse company operates multiple types of healthcare services dedicated to improving the quality of care in a convenient and cost-effective manner.
Our integrated approach to advancing markets allows for flexibility to provide care on an individualized, local market basis. Whether entering into a new market with surgical facilities, ancillary services or joint ventures with health systems, or furthering an existing market’s growth potential by focusing on base business, in-market development and new service lines, our experience has shown us that no two markets are alike. We see value in individuality.
At Surgery Partners, our mission is to enhance patient quality of life through partnership. Surgery Partners is an organization deeply committed to providing quality, compassionate and personalized care, to meet the needs of our diverse patients, employees and physician partners in the communities in which we serve. Our colleagues are critical in achieving that mission. As it truly brings out the best in all of us, Surgery Partners is committed to diversity and inclusion.
Our Surgery Partners team is comprised of more than 15,000 employees and 4,600 affiliated physicians, serving more than 600,000 patients annually. Want to work with us? Check out our website for current employment opportunities.
