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Surgery Authorization Specialist

2 months ago

Montgomery, United States Sterling Ridge Orthopaedics and Sports Medicine Full time
Job DescriptionJob DescriptionDescription:

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.
Requirements:

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.