Procedure Authorization Specialist- Full time

Procedure Authorization Specialist- Full time

Job Category: APP Supervisor: Ryan Clough

Full-Time

Corporate Office Phoenix, AZ 85023, USA

Description

Benefits:

• 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

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

HOPCo | Healthcare Outcomes Performance Company