Remote RCM Authorizations Specialist

Sports Medicine North; Stamford (CT); Remote; USD 30,000 - 45,000; Full time

Job summary

Spire Orthopedic Partners is seeking an experienced RCM Authorizations Representative to review authorization requirements for surgeries, therapies, imaging and DME. You will coordinate with outsourced auth vendors, clinical staff and scheduling teams to ensure timely approvals and smooth patient care.

The role emphasizes accurate documentation, confidentiality, and strong communication with providers and patients, with a fully remote work arrangement.

Qualifications

• Minimum of one-year prior authorization experience required.
• Knowledge of Orthopedic procedures helpful but not essential.
• Excellent telephone etiquette and good communication skills (written and oral).
• Computer literacy skills preferred, including practice management software, EMR, Microsoft Word and Excel.
• Detail oriented and strong organizational skills preferred.
• Familiar with Local Coverage Insurance Plans.

Responsibilities

• Review EHR task lists to determine authorization requirements for Commercial Surgery, Physical Therapy, MRI/CT Scans, Injections/VISCO and DME/Bone Stimulators.
• Review orders and dictations in EHR regarding requests and keep lists updated.
• Document correspondence/updates on orders with status.
• Notify providers and arrange Peer to Peer requests and follow up on outcomes.
• Inform Clinical and Radiology staff of changes to authorization requirements.
• Serve as direct contact for outsourced authorization companies to ensure timely turnaround per contract.
• Coordinate with Operations leadership and PCCs on scheduling needs.
• Provide resource for the team; be the first line of response to workflow issues and inform staff of changes.
• Maintain auth team task list and confidentiality of patient data in EMR.
• Communicate with providers and patients; monitor team communication and decision making.
• Support scheduling and patient care with RCM and Operational teams.

Skills

Telephone etiquette

Communication skills

Education

High school diploma or equivalent

Tools

Practice management software

EMR

Microsoft Word

Excel

Job description

Spire Orthopedic Partners is seeking an experienced RCM Authorizations Representative to review authorization requirements for surgeries, therapies, imaging and DME. You will coordinate with outsourced auth vendors, clinical staff and scheduling teams to ensure timely approvals and smooth patient care.

The role emphasizes accurate documentation, confidentiality, and strong communication with providers and patients, with a fully remote work arrangement.