Surgical Authorization Specialist

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

📋 Description

• Oversee the authorization process for upcoming surgical cases scheduled on physicians’ calendars, ensuring that authorizations are timely and accurate.

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

• Update and verify the necessary information required to process claims for insurance plans.

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

• Validate benefits for all surgical procedures.

• Record authorizations and track authorization progress in patients’ records.

• Input authorization details into case management systems.

• Communicate effectively with physicians, patients, and colleagues, fostering positive working relationships with both internal and external stakeholders.

• Engage in ongoing staff training and education concerning new processes.

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

• Assist surgery schedulers with urgent (STAT) authorizations.

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

• Identify opportunities for workflow enhancements.

• Attend departmental meetings as needed.

⛳️ Requirements

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

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

• Exceptional organizational abilities.

• Strong focus on customer service.

• Proficient in computer skills and data entry.

• Familiarity with eligibility verification and benefits verification processes.

• Knowledge of prior authorizations.

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

• Effective communication skills with physicians, patients, and colleagues.

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

• Capacity to maintain confidentiality regarding health records and member information.

• Understanding of and ability to comply with HIPAA regulations.

🏝️ Benefits

• Competitive Health & Welfare Benefits.

• Monthly $43 stipend available for ancillary benefits.

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

• 401k plan after 6 months of service, inclusive of company match (applicable for part-time employees).

• 24/7 Employee Assistance Program to provide support.

• Employee Wellness Events.