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Surgery Authorization Specialist
3 months ago
We are looking for a full-time Surgery Authorization Specialist to join our top notch team of professionals
Position will be located at our Woodforest office.
Woodforest: 750 Fish Creek Thoroughfare Montgomery, TX 77316
Previous experience with orthopedics is preferred but not required
Hours:
8:00 AM to 5:00 PM or 8:30 AM to 5:30 PM with rotating Saturdays (every 6-8 weeks from 8:00 AM to 12:15 PM)
Job Summary:
- Responsible for all aspects of insurance verification and authorizations. Primary focus on Surgery Authorizations, VISCO injections. DME and MRI obtaining benefits, getting authorizations, and scheduling patients.
Essential Duties:
- Responds promptly to patient and staff needs.
- Verify insurance eligibility, benefits, and pre-authorization/pre-certification via telephone and internet.
- Initiate the process of obtaining prior authorization, if required, to maximize the opportunity for reimbursement.
- Update patient information as needed in Athena.
- Participates in facility committees, meetings, in-services, and activities.
- Compliant with HIPAA, OSHA, state and federal regulation, and company policies and procedures.
- Perform other miscellaneous office/clerical duties as needed.
Education and Qualifications:
- High School Diploma or GED certificate.
- Graduate of a certified medical office training course preferred
- Basic knowledge of ICD-10 coding and CPT codes
- 2 years’ experience surgery authorization process required.
- Knowledge of EMRs, Athena preferred.