Surgical Authorization Specialist

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Oversee the authorization process for upcoming surgical procedures on physicians’ schedules

• Ensure that surgical authorizations are accurately obtained and processed in a timely manner

• Validate patient demographic information, insurance eligibility, and benefit coordination

• Update necessary information for claims processing

• Complete forms for surgical cost analysis and document cost estimates for collection prior to services

• Confirm benefits for surgical procedures

• Record the progress of authorizations in patient charts and case management systems

• Provide continuous training and education for staff on updated processes

• Collaborate with the department manager to address and mitigate complaints

• Assist surgery schedulers with urgent (STAT) authorizations

• Uphold the confidentiality of health records and member information in compliance with HIPAA regulations

• Recognize opportunities for workflow enhancements

• Attend departmental meetings as necessary

⛳️ Requirements

• High school diploma/GED or equivalent practical knowledge is preferred

• At least 2 years of experience in the healthcare sector is required

• Prior experience in referrals/authorizations, front office operations, and/or charge posting is preferred

• Exceptional organizational skills and a strong focus on customer service are required

• Solid computer skills and proficiency in data entry

• Working knowledge of eligibility, benefit verification, and prior authorizations from diverse HMOs, PPOs, commercial payers, and other funding sources

• Familiarity with federal, state, and HIPAA privacy regulations

• Understanding of computer applications

• Proficient in organizing billing requirements and authorization processes

• Competence in using Microsoft Excel, Microsoft Word, and Outlook

• Ability to manage multiple tasks in a fast-paced setting

• Detail-oriented with strong organizational abilities

• Capability to comprehend patient demographic information and assess insurance eligibility

• Ability to work independently and analyze data

• Skilled in effective and compassionate communication with patients, colleagues, management, and providers

🏝️ Benefits

• Competitive salary and performance-based incentives

• Comprehensive health, dental, and vision insurance plans

• Retirement savings plan with employer matching

• Paid time off and holiday pay

• Opportunities for professional development and continuing education