PT/OT Referral Authorization Specialist

Excel Orthopaedic Specialists in Woburn is hiring.  We are a busy Orthopedic practice looking to hire a Referral/Authorization Specialists to add to our expanding team. The Referral / Authorization Specialist is responsible for processing referrals and prior authorizations to ensure that patient visits and procedures are covered by various payers. 

• Proactively reviews OT and PT therapy schedules to determine which patients need referral or prior authorizations
• Verifies patient eligibility (insurance, worker’s comp, MVA)
• Prepares, processes and tracks referrals and prior authorizations through various payer systems, documents all in eCW per protocol
• Makes follow up calls to patients and payers (insurance company, workers comp, etc)
• Responds to questions and requests from leadership, providers, payers and patients
• Demonstrate professional communication and problem solving with providers and leadership, participate in process improvement and educate teams on updated guidelines and/or process.
• Completes other tasks as directed by management.
• Attends staff meetings and continuing education