Procedure Authorization Specialist

2 months ago


Phoenix, United States Center for Orthopedic and Research Excel Full time
Job DescriptionJob Description

Benefits:

  • $18.00-$21.00/HR
  • Competitive Health & Welfare Benefits
  • HSA with qualifying HDHP plans with company match
  • 401k plan after 6 months of service with company match (Part-time employees included)
  • Employee Assistance Program that is available 24/7 to provide support
  • Employee Appreciation Days
  • Employee Wellness Events

Minimum Qualifications:

  • Two years of experience in the healthcare field is required with previous call center experience is preferred.
  • Minimum one year in Prior Auth and or Insurance verification

Preferred: Experience in Spinal Cord, Kyphoplasty and Imaging highly preferred

Essential Functions

  • Monitors the authorizations of upcoming surgical cases on the physician’s calendars ensuring authorizations for surgeries are obtained in a timely and accurate manner.
  • Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans.
  • Accurately completes surgical cost analysis form, documenting the required surgical cost estimation for collection prior to services.
  • Verifies benefits on all surgical procedures.
  • Document authorizations and progress of authorizations in the patient’s chart. Enters the authorization information within case management.
  • Must be able to communicate effectively with physicians, patients, and co-workers and be capable of establishing good working relationships with both internal and external customers.
  • Participate in providing ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases.
  • Work with department manager to respond to and reduce complaints timely and professionally.
  • Assist surgery schedulers with STAT authorizations.
  • Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines.
  • Assists in identifying opportunities for improvement within the daily workflow process.
  • Attends department meetings as required.

About us:

The Center for Orthopedic Research and Education, We don't mean to brag but did you know The CORE Institute has been ranked by Ranking Arizona: The Best of Arizona Businesses?

  • #1 for Orthopedic Practices
  • #1 for Healthiest Healthcare Employers
  • #3 for Best Healthcare Workplace Culture


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