Surgical Authorization Specialist

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

📋 Description

• Oversee authorizations for scheduled surgical cases on the calendars of physicians.

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

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

• Update and validate information necessary for claims processing.

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

• Confirm benefits for all surgical procedures.

• Record authorization status and progress in patient records and case management systems.

• Provide continuous training and education for staff regarding updated processes.

• Collaborate with the department manager to address and minimize complaints.

• Support surgery schedulers with urgent authorizations.

• Identify areas for improvement in daily workflow processes.

• Attend departmental meetings as required.

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

⛳️ Requirements

• High school diploma/GED or equivalent experience preferred.

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

• Previous exposure to referrals/authorizations, front office duties, and/or charge posting is preferred.

• Strong organizational skills and a solid customer service orientation are required.

• Proficiency in computer use and data entry is essential.

• Familiarity with eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers, and other funding sources.

• Understanding of federal, state, and HIPAA privacy regulations.

• Knowledge of computer applications is necessary.

• Competence in organizing and managing billing requirements and authorization processes.

• Proficiency in Microsoft Excel, Microsoft Word, and Outlook.

• Ability to multitask in a fast-paced environment.

• Detail-oriented with strong organizational capabilities.

• Ability to comprehend patient demographic information and assess insurance eligibility.

• Capacity to work independently and analyze data effectively.

• Excellent communication skills, with the ability to interact compassionately with patients, colleagues, management, and providers.

• Must adhere to HIPAA regulations and maintain strict confidentiality of health records and member information.

🏝️ Benefits

• Full-Time employment.

• Remote work arrangement.