Surgical Authorziation Specialist

Seeking immediate hire to join our Business Office as an Authorization Specialist in a high‑profile Sports Medicine Group supporting 15 physicians and 6 clinic locations.

DUTIES INCLUDE, BUT ARE NOT LIMITED TO:

Interpret insurance benefits and calculate patient responsibility Review chart documentation to ensure patient meets medical policy guidelines Prioritize incoming authorization requests according to urgency Obtain authorizations via payer portals or by phone and follow up regularly on pending cases Initiate appeals for denied authorizations Respond to clinic questions regarding payer medical policy guidelines Confirm accuracy of CPT and ICD‑10 diagnoses in the procedure order Contact patients to discuss authorization status Other duties as assigned Qualifications: Knowledge of commercial and governmental insurance plans (HMO, PPO, EPO, etc.) and payer portals Knowledge of NextGen EHR software (preferred) MS Office, basic office support skills (telephone, filing, data entry) and basic math skills Excellent telephone etiquette, pleasant personality and customer service skills Ability to multitask and remain focused while managing a high‑volume, time‑sensitive workload Plans and prioritizes to meet deadlines Experience: 2 years medical prior authorization and verification experience required 2 years experience in a medical related field required High school diploma or GED required Job Type: Full‑time – Monday through Friday with a few rotating Saturday mornings. Traveling involved from one clinic to another based on schedule. Dependable transportation required. Benefits: Medical, Dental, Vision, Short Term Disability, Long Term Disability, Life Insurance and 401K 401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance Schedule: 8 hour shift Day shift Monday to Friday Weekend availability Education: High school or equivalent (Required) #J-18808-Ljbffr Sportsmedsa