Procedure Authorization Specialist- Full time

Job Description

Job 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