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Surgical Authorization Specialist
1 month ago
The Orthopedic Surgical Authorization Specialist (SAS) will work under the direction of the Assistant Director and Director to facilitate and coordinate orthopedic patient care both in and outside the hospital setting. The SAS will be the point of contact/resource for patients, staff, physicians, and insurance companies. The SAS will possess excellent communication skills and be detail-oriented to build collegial relationships with surgeons, patients and hospital departments.
Qualifications:
Education:
- High school diploma required.
- Previous experience in insurance prior authorization processing required.
- Previous experience working in customer service required.
- A minimum of one (1) year previous experience in a physician's office and/or experience preferred.
- A minimum of two (2) years' previous experience working in an office environment preferred.
- Previous experience in surgical scheduling preferred.
- Certified Medical Assistant (CMA) through an accredited agency preferred.
- Schedule hospital and ASC based surgical/medical procedures for patients with providers according to specific surgical block times according to location, utilizing appropriate scheduling protocols to ensure maximum schedule efficiency.
- Verify insurance benefits, work with insurance companies to submit medical documentation to obtain prior authorizations.
- Interface with appropriate vendor staff to ensure all necessary equipment will be on site for hospital and ASC procedures.
- Interface with appropriate office/ASC/hospital staff to ensure a cohesive working relationship in providing patient care services.
- Enter notes/special instructions needed for scheduling in the electronic medical record system.
- Effectively utilizes clinical knowledge when determining if a medical clearance appointment is consistent with the diagnosis and/or indications indicated by provider and ensures appointments are made for patients and confirms all appointment times with patients via telephone.
- Reviews discharge instructions with patients and ensures proper post-op appointments are scheduled at the time the surgery/procedure is scheduled for after-care follow-up.
- Completes accurate documentation of informed consent with patients for procedures and surgeries as needed.
- Provides accurate, detailed information to patients regarding test preparations, time of patients scheduled arrival, and any other directional information needed; takes appropriate action in responding to questions from patients.
- Responsibilities include updating patient demographic files, assure accurate information is entered in Electronic Medical Records (EMR) as needed.
- Serve as the primary liaison between the patient and their medical team for surgical related questions/concerns.
- Assist/complete other duties as assigned beyond those designated in this primary job description by the Service Line Director, Assistant Director, and Practice Provider.
- Greet all patients and their accompanying family members when applicable and provide exemplary customer service.
- Work effectively and collaboratively with colleagues, physicians, and department heads.
- Effectively utilize strong organizational skills.
- Consistently display effective verbal communication skills.
- Proficient understanding and use of technology/PC skills required.
- Regularly exercise independent judgment in all situations.
- Complete other duties as assigned by department leadership.