Authorization Specialist

Socket.dev; Glen Mills (Delaware County); On-site; USD 36,000 - 56,000; Full time

Job summary

Premier Orthopaedics & Philadelphia Hand to Shoulder in Glen Mills seeks an Authorization Specialist to join our on-site team. The role focuses on obtaining prior authorizations for surgical procedures, verifying patient demographics and insurance eligibility, and supporting accurate cost estimations.

This full-time, on-site position requires strong organizational skills, HIPAA knowledge, and collaborative communication with physicians, staff, and patients to ensure timely care.

Qualifications

• High school diploma or GED required with healthcare exposure.
• Minimum 2 years’ experience in healthcare settings.
• Experience with referrals/authorizations and front office tasks preferred.
• Working knowledge of eligibility, verification of benefits, and prior authorizations.
• Familiarity with HIPAA privacy regulations and patient data handling.

Responsibilities

• Monitors authorizations for upcoming surgical cases on physician calendars and ensures timely approvals.
• Verifies patient demographics and insurance eligibility, and coordinates benefits.
• Completes surgical cost analysis forms and documents required cost estimates.
• Verifies benefits on all Visco injections and documents authorizations.
• Records authorizations in the patient chart and case management system.
• Communicates effectively with physicians, patients, and coworkers to maintain strong working relationships.
• Participates in staff training on new processes to ensure timely confirmations of surgical cases.
• Assists surgery schedulers with STAT authorizations.

Skills

Authorization process

Customer service

Verbal/written communication

Attention to detail

Education

High school diploma/GED

2 years healthcare experience

Experience with referrals/authorizations

HIPAA privacy regulations

Tools

Computer applications

Microsoft Excel

Job description

Title: Authorization Specialist
Location: Glen Mills
Organization: Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder

Overview

Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is seeking a dedicated and skilled Authorization Specialist to join our team at our Glen Mills office. As two of the region’s most respected providers of orthopedic and upper extremity care, we offer a collaborative, patient-focused environment that prioritizes clinical excellence, innovation, and ongoing professional development.This is a full time on-site Monday-Friday position.

ESSENTIAL FUNCTIONS

• Monitors the authorizations of upcoming surgical cases on the physician’s calendars ensuring authorizations for Viscosupplementation injections are obtained in a timely and accurate manor.
• 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 Visco injections.
• Document’s 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.

EDUCATION

• High school diploma/GED or equivalent working knowledge preferred
• Minimum of 2 years’ experience in healthcare field is required and previous experience in referrals/authorizations, front office, and/or charge posting is preferred.
• Excellent organizational skills and strong customer service orientation are required with strong background with computers and data entry.
• Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers and other funding sources.
• Federal, state and HIPAA privacy regulations.
• Knowledge of computer applications.

About Premier Orthopaedics & Philadelphia Hand to Shoulder

About Premier Orthopaedics & Philadelphia Hand to Shoulder
Premier Orthopaedics and Philadelphia Hand to Shoulder Center (PHSC) are leading providers of comprehensive musculoskeletal care throughout Pennsylvania, New Jersey and Delaware.

Premier Orthopaedics delivers expert treatment for orthopedic injuries, joint disease, interventional spine care, regenerative medicine, and comprehensive physical therapy services, supported by more than 1200 providers across 50+ locations. Our facilities include state-of-the-art MRI centers, outpatient surgery centers, physical therapy clinics, and orthopedic urgent care centers to ensure timely access to high-quality, patient-focused care.

Philadelphia Hand to Shoulder Center (PHSC), a division of Premier Orthopaedics, has been nationally recognized for more than 50 years for its specialized care of the hand, wrist, elbow, arm, and shoulder. Our fellowship-trained surgeons and certified Hand and Occupational Therapists collaborate to provide seamless care—from diagnosis and treatment to post-operative and rehabilitive recovery. With 20+ convenient locations across Pennsylvania and New Jersey, PHSC offers advanced, integrated care to restore function, mobility, and quality of life for patients with upper extremity conditions.