Spine Surgery Prior-Authorization Specialist

Winning Assistants LLC.; Hinoba-an; Hybrid; PHP 433,000 - 607,000; Full time

Job summary

Winning Assistants LLC. is seeking a Medical Authorization Specialist (Spine Surgery) to support a U.S.-based spine care practice from a remote location.

The role involves processing surgical authorizations, insurance appeals, and portal navigation to ensure timely, accurate approvals. Ideal candidates will have hands-on experience with prior authorizations, direct insurer communication, and familiarity with spine/orthopedic procedure codes.

Qualifications

• Hands-on surgery authorization experience is required.
• Experience navigating multiple insurance portals is required.
• Strong understanding of prior authorization and appeals process is required.
• Experience communicating with insurance companies is required.
• Experience submitting and tracking authorization requests from start to completion.
• Experience handling denials and supporting appeals.
• Ability to determine documentation required by different insurers.
• Familiarity with medical procedure codes and HIPAA rules.

Responsibilities

• Manage and process surgery authorizations for orthopedic and spine procedures.
• Review requirements and verify insurance information.
• Submit prior authorization requests via insurance portals.
• Track authorizations from submission to determination.
• Ensure documentation is complete and accurate.
• Follow up on pending authorizations and requirements.
• Maintain records of status, references, and communications.
• Support claims verification and related tasks as needed.
• Review codes and clinical notes to support authorizations.
• Navigate Epic, Cerner, Athena and other systems for data.

Skills

Surgery authorization experience

Insurance portal navigation

Prior authorization process

Insurance appeals management

Communication with insurance reps

Documentation and tracking

HIPAA compliance

EHR/EMR familiarity

Tools

Epic

Cerner

Athena

EHR/EMR systems

Google Sheets

Microsoft Teams

Job description

Winning Assistants LLC. is seeking a Medical Authorization Specialist (Spine Surgery) to support a U.S.-based spine care practice from a remote location.

The role involves processing surgical authorizations, insurance appeals, and portal navigation to ensure timely, accurate approvals. Ideal candidates will have hands-on experience with prior authorizations, direct insurer communication, and familiarity with spine/orthopedic procedure codes.