Surgical Authorization Specialist

3 weeks ago

Mesa, United States Western Vascular Institute Full time

Western Vascular Institute is looking for a Full-Time Surgical Authorization Specialist to join our busy Vascular Clinic

We are looking for a hardworking and positive individual. As a Surgical Authorization Specialist, you must have the ability to multi-task in a fast-paced environment, to work closely with other individuals requiring the ability to work as a team.

As a Surgical Authorization Specialist, you will be responsible for obtaining prior authorizations to schedule procedures. Which are to include coordinating the surgical procedures with the Surgery Scheduling Department and working with the patients and the insurance companies to obtain the prior authorization.

**ESSENTIAL FUNCTIONS - PRINCIPAL DUTIES AND RESPONSIBILITIES**:

- 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 the Surgery Scheduling team and 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.

**QUALIFICATIONS AND SKILLS**:

- High school diploma or GED required
- 1+ years surgery scheduling, Prior Auth and or Insurance Verification. Must be able to communicate effectively with physicians, patients and the public and be capable of establishing good working relationships with both internal and external customers.
- Strong knowledge of clinical / medical practice operations, procedures, terminology, and administrative procedures.
- Must be flexible and can multi task.
- Ability to collaborate across departments and build effective relationships with internal and external customers/insurance companies to achieve goals.
- Possession of strong problem-solving skills and sound judgment.
- Ability to achieve team goals while demonstrating organizational values and utilizing resources responsibly.
- Ability to be proactive and take initiative.
- Exhibit high level of quality through attention to detail and monitoring of work.
- Possession of strong organizational skills.
- Excellent verbal and written communication, as well as, exceptional interpersonal communication skills.
- Ability to work independently on assigned tasks as well as to accept direction on given assignments.
- Deals with confidential information and/or issues using discretion and judgment.

**BENEFITS**:

- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Health insurance
- Life insurance
- Paid time off & Paid Sick Time
- Vision insurance
- Compensation will be dependent on experience and should be discussed during the interviewing process._

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