Orthopedic Prior Authorization Specialist — Make a Difference

OrthoArizona; Peoria (AZ); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Robust paid time off

Medical insurance

Health Savings Account

Job summary

OrthoArizona is seeking a Surgical Prior Authorization Specialist in Peoria, AZ. The role focuses on verifying insurance authorization requirements, ensuring documentation supports medical necessity, and submitting authorizations with correct CPT and diagnosis codes.

You will enter authorization data into EMR and monitor status to prevent denials. The position requires at least 2 years in healthcare administration, with strong customer service and knowledge of medical terminology.

Qualifications

• Minimum of 2 years of experience in healthcare administration or related field.
• Excellent customer/patient service and knowledge of medical terminology.
• Strong written and verbal communication skills.
• Ability to promote a positive facility image with physicians, patients, and insurers.
• Ability to work with telephone communication and team collaboration.
• Understanding of insurance authorization processes and procedures.
• Follows standard operating procedures.

Responsibilities

• Verify insurance authorization requirements for ordered services/procedures.
• Submit authorizations with correct CPT and diagnosis codes.
• Ensure documentation is complete before submitting to avoid denials.
• Enter authorization numbers and expiration dates into EMR.
• Monitor and resolve status of problem authorizations.
• Maintain medical records per policy.
• Estimate prepay amounts and collect co-insurance, copays, deductibles, or self-pay rates.

Skills

Customer service

Medical terminology

Verbal communication

Telephone communication

Organization

Independent/work in team

Insurance authorization processes

Decision making/problem solving

Education

High School diploma or GED

Tools

EMR systems

Practice management software

Computer programs

Job description

OrthoArizona is seeking a Surgical Prior Authorization Specialist in Peoria, AZ. The role focuses on verifying insurance authorization requirements, ensuring documentation supports medical necessity, and submitting authorizations with correct CPT and diagnosis codes.

You will enter authorization data into EMR and monitor status to prevent denials. The position requires at least 2 years in healthcare administration, with strong customer service and knowledge of medical terminology.