Surgical Authorization Specialist

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

📋 Description

• Oversee the authorization processes for upcoming surgical cases on physicians’ schedules, ensuring timely and accurate acquisition of surgery authorizations.

• Confirm patient demographic details and insurance eligibility, including the coordination of benefits.

• Update and verify the necessary information for processing claims with insurance providers.

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

• Validate benefits for all surgical procedures.

• Document authorizations and track authorization progress in patient charts.

• Input authorization details in case management systems.

• Communicate effectively with physicians, patients, colleagues, and both internal and external clients.

• Engage in continuous staff training and education on new processes.

• Collaborate with the department manager to address and minimize complaints in a timely and professional manner.

• Assist surgical schedulers with urgent authorizations.

• Uphold strict confidentiality of health records and member information, adhering to HIPAA regulations.

• Identify opportunities to enhance daily workflow processes.

• Attend departmental meetings as required.

⛳️ Requirements

• A minimum of 2 years of experience in the healthcare sector is required.

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

• Excellent organizational skills are essential.

• Strong customer service focus is required.

• Solid background in computer skills and data entry is necessary.

• Familiarity with eligibility verification, benefits verification, and prior authorizations is important.

• Experience working with HMOs, PPOs, commercial payers, and other funding sources is beneficial.

• Ability to communicate effectively with physicians, patients, and coworkers is crucial.

• Capacity to build positive working relationships with both internal and external customers.

• Ability to maintain strict confidentiality of health records and member information is required.

• Knowledge of and compliance with HIPAA regulations is necessary.

🏝️ Benefits

• Competitive Health & Welfare Benefits.

• Monthly $43 stipend for ancillary benefits.

• Health Savings Account (HSA) with qualifying High Deductible Health Plans (HDHP) and company match.

• 401k plan available after 6 months of service, with company match (includes part-time employees).

• 24/7 Employee Assistance Program providing support.

• Employee Wellness Events.