Complex Case Insurance Authorization Coordinator

Summit Spine & Joint Centers; Lawrenceville (GA); On-site; USD 45,000 - 60,000; Full time

Job summary

A multi-state healthcare organization is seeking a Complex Case Insurance Authorization Coordinator in Lawrenceville, GA. This full-time role involves processing insurance authorizations for surgical procedures, maintaining organized files, and addressing patient concerns. Ideal candidates will have at least 2 years of outpatient medical office experience, excellent communication skills, and a solid understanding of insurance protocols. Join our team to support high-quality patient care in a dynamic environment.

Qualifications

• Minimum of 2 years' experience in an outpatient medical office, preferably in Insurance Authorization.
• Excellent knowledge of CPT coding and ICD.10 coding is required.
• Familiarity with Medicare and Commercial Insurances is a must.

Responsibilities

• Process insurance authorizations for complex surgical procedures.
• Research and resolve pending procedure authorizations timely.
• Coordinate patient financial responsibilities related to service.

Skills

Detail-oriented

Excellent verbal and written communication

Bilingual

Problem-solving

Multi-tasking

Education

2 years' experience in outpatient medical office

Knowledge of CPT and ICD.10 coding

Experience in Insurance Authorization

Tools

eClinicalWorks

Authorization portals

Job description

Company Overview

Summit Spine and Joint Centers (SSJC) is a rapidly growing, multi-state Interventional Pain Management group practice providing integrated clinical, surgical, and imaging services. With clinic locations across Georgia, North Carolina, South Carolina, and Tennessee, our care teams include Integrated Pain Solutions in North Carolina and Savannah Pain Management in Georgia, all operating as part of the SSJC organization. As one of the largest single-specialty practices in the nation, we are committed to collaboration, high-quality patient-centered care, and supporting our teams as we continue to expand. We are seeking motivated, qualified professionals to join us in delivering exceptional care across our growing network.

Summary of Position

Under general supervision of a licensed provider, as a Complex Case Insurance Authorization Coordinator one must perform insurance authorizations for complex surgical procedures such as SCS trials and implants, Vertiflex implants, SI Joint Fusions, NALU/Sprint Peripheral Nerve Stimulators, Intracepts, VIA DISCs, etc. We are seeking motivated individuals who can problem-solve and multitask as we are a fast-paced practice. Gain skills and knowledge of organization policies and procedures in support of the department. This job is a full-time, benefited position at Summit Spine & Joint Centers that reports to the Director of Operations. This position’s primary location will be at the Administrative Building in Lawrenceville, GA.

Responsibilities

• Routinely provide patients with other clinic and community-based resource materials as appropriate.
• Research, follow up and resolve open & pending procedure authorizations in a timely manner.
• Verify insurance eligibility and benefits of prospects/referrals.
• Comfortable working in a growing organization and able to navigate change.
• Address insurance related patient concerns.
• Self-motivated with the ability to multi-task and prioritize work in a fast-paced team environment.
• Review schedule ahead of time to determine pre-certification and prior authorization requirements.
• Obtain authorizations by using online applications or by contacting insurance company directly.
• Must be familiar with Medicare and Commercial Insurances.
• Maintain organized working files of all authorization requests and enter approved authorizations into the system.
• Coordinate and document all financial responsibilities related to patient deductibles, coinsurance, and copays owed at the time of service.

Skills And Abilities

• Must be personable and detail oriented as a representative of the practice while callers rely on proper information.
• Excellent verbal and written skills for proper documentation of encounters.
• Bilingual candidates are encouraged to apply.

Education And Experience

• Minimum of 2 years' experience in an outpatient medical office, working in an Insurance Authorization or Pre Authorization/Certification role.
• Excellent knowledge of CPT coding, ICD.10 coding and medical pre-certification protocols required.
• Authorization portal experience preferred.
• Experience in Pain Management preferred.
• Experience using eClinicalWorks preferred.