Orthopedic Spine Preauthorization Pro – Impactful & Detail‑Driven

North Florida Surgeons, P.A.; Fort Walton Beach (FL); Vor Ort; USD 42.000 - 60.000; Vollzeit

Benefits dieser Stelle

Competitive salary

Medical, dental, and vision benefits

Paid time off and holidays

401(k) or retirement plan

Zusammenfassung

North Florida Surgeons, P.A. is seeking a meticulous Orthopedic/Spine Preauthorization Specialist to verify coverage, gather medical records, and process preauthorizations for orthopedic, imaging, surgery, pain management, and spine procedures.

You will collaborate with schedulers, providers, insurers, and patients to secure timely approvals. The role requires 1+ years in authorizations or medical billing, strong orthopedic knowledge, and proficiency with EMR and payer portals.

Qualifikationen

• 1+ years’ experience in prior authorizations, insurance verification, utilization review, or medical billing.
• High school diploma or GED required; healthcare-related certificate or associate degree preferred.
• Strong knowledge of orthopedic procedures, treatments, and medical terminology.
• Familiarity with payer portals, EMRs (e.g., Athena, Availity Humana Military), CPT/ICD-10 basics.
• Attention to detail and ability to analyze complex medical documentation.
• Strong communication skills and ability to interact with healthcare professionals, insurers, and patients.
• Proficient computer skills, including EMR systems.
• Ability to work independently and as part of a team, meeting deadlines in a fast-paced environment.
• Commitment to HIPAA guidelines and patient confidentiality.
• Bilingual skills a plus (Spanish/ASL).

Aufgaben

• Review and evaluate preauthorization requests for orthopedic procedures and treatments, ensuring completeness and accuracy of documentation.
• Verify patient insurance coverage and eligibility for requested services.
• Collaborate with clinical staff to gather necessary medical records and supporting documentation.
• Communicate effectively with insurance companies to obtain preauthorization approvals
• Maintain accurate and up-to-date records of preauthorization requests, approvals, and denials status.
• Educate healthcare providers on preauthorization requirements and assist in resolving related issues.
• Stay updated on insurance industry regulations, policies, and guidelines related to orthopedic preauthorization.

Kenntnisse

Prior authorizations

Insurance verification

Utilization review

Medical billing

Orthopedics/spine knowledge

EMR systems

CPT/ICD-10 basics

Ausbildung

High school diploma or GED

Healthcare-related certificate or associate degree

Tools

Athena

Availity

Humana Military

Jobbeschreibung

North Florida Surgeons, P.A. is seeking a meticulous Orthopedic/Spine Preauthorization Specialist to verify coverage, gather medical records, and process preauthorizations for orthopedic, imaging, surgery, pain management, and spine procedures.

You will collaborate with schedulers, providers, insurers, and patients to secure timely approvals. The role requires 1+ years in authorizations or medical billing, strong orthopedic knowledge, and proficiency with EMR and payer portals.