Orthopedic Preauthorization Specialist: Streamline Care

Nflsurgeons; Fort Walton Beach (FL); In loco; USD 42.000 - 64.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, and vision benefits

Paid time off and holiday pay

401(k) or retirement plan options

Supportive team environment and growth

Descrizione del lavoro

Nflsurgeons in Fort Walton Beach, FL seeks an Orthopedic/Spine Preauthorization Specialist to join our healthcare team. You will review preauthorization requests for orthopedic, imaging, surgery, pain management, spine procedures, DME, and PT, and coordinate with schedulers, providers, insurers, and patients to secure timely approvals.

Responsibilities include verifying coverage, gathering records, guiding providers on requirements, and maintaining detailed case documentation.

Competenze

• 1+ years’ experience in prior authorizations, insurance verification, utilization review, or medical billing.
• Healthcare background in orthopedics, spine, or pain management preferred.
• High school diploma or GED; healthcare-related certificate/associate degree preferred.
• Familiarity with payer portals and EMRs (Athena, Availity Humana Military, etc.).
• Attention to detail; ability to analyze complex medical documentation.
• Strong written and verbal communication with healthcare providers, insurers, and patients.
• Proficient with EMR systems; HIPAA compliant.
• Bilingual skills a plus (Spanish/ASL).

Mansioni

• Review and process preauthorization requests for orthopedic procedures and related services.
• Verify patient insurance coverage and eligibility for requested services.
• Collaborate with clinical staff to gather medical records and documentation.
• Communicate with insurance companies to obtain preauthorization approvals.
• Maintain accurate records of preauthorizations, approvals, and denials.
• Educate healthcare providers on preauthorization requirements and resolve issues.
• Stay updated on insurance regulations and guidelines.

Conoscenze

Prior authorization

Insurance verification

Utilization review

Medical billing

Orthopedics knowledge

Spine/pain management

Payer portals

EMR proficiency

HIPAA compliance

Communication skills

Formazione

High school diploma or GED

Healthcare-related certificate or associate degree preferred

Strumenti

Athena EMR

Availity Humana Military

CPT/ICD-10 basics

Descrizione del lavoro

Nflsurgeons in Fort Walton Beach, FL seeks an Orthopedic/Spine Preauthorization Specialist to join our healthcare team. You will review preauthorization requests for orthopedic, imaging, surgery, pain management, spine procedures, DME, and PT, and coordinate with schedulers, providers, insurers, and patients to secure timely approvals.

Responsibilities include verifying coverage, gathering records, guiding providers on requirements, and maintaining detailed case documentation.