Outpatient Surgical Preauthorization Specialist

Wheaton Eye Clinic; Wheaton (IL); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Medical

Group Life and LTD

Paid Time Off

Paid Holidays

Clothing Allowance

Vision Care Benefits

Voluntary Benefit Offerings - Life,STD

Job summary

Wheaton Eye Clinic in Wheaton, IL seeks a Surgical Precertification Specialist to obtain preauthorizations for outpatient surgeries. This in-office role requires strong communication and customer service, plus knowledge of ICD-10 and medical terminology.

You will liaise with insurance companies, primary care physicians, and utilization management organizations, ensuring timely approvals and minimal cancellations.

Qualifications

• Outstanding communication and customer service skills.
• Knowledge of ICD-10 and medical terminology.
• Ability to read, write and speak clearly and professionally.
• 1-2 years insurance experience with prior authorization processes preferred and 1-2 years medical scheduling experience preferred.

Responsibilities

• Obtain preauthorization for outpatient surgeries from insurance companies.
• Communicate with primary care physicians and utilization management organizations to obtain authorizations.
• Follow up on requests to ensure timely responses and prevent last-minute cancellations.
• Communicate denials and coordinate with surgeon, patient, facility and scheduling staff as needed.
• Investigate denials with the Insurance Department and submit appeals when necessary.
• Assist with urgent add-on surgery authorizations and respond to inquiries from patients and case managers.

Skills

Communication skills

Customer service

Medical terminology

Education

High school diploma or equivalent

Job description

Wheaton Eye Clinic in Wheaton, IL seeks a Surgical Precertification Specialist to obtain preauthorizations for outpatient surgeries. This in-office role requires strong communication and customer service, plus knowledge of ICD-10 and medical terminology.

You will liaise with insurance companies, primary care physicians, and utilization management organizations, ensuring timely approvals and minimal cancellations.