Remote Surgery Authorization Specialist II

ENT Specialty Partners; Irving (TX); On-site; USD 60,000 - 78,000; Full time

Job summary

ENT Specialty Partners is seeking a Revenue Cycle Specialist II - Surgery Authorization Specialist to support surgical services nationwide. This fully remote role requires expertise in insurance verification, pre-authorizations, and payer communications to ensure timely approvals and accurate patient billing.

You will review benefits, determine medical necessity, document activity in EMR/EPM, and collaborate with clinical teams to resolve complex authorization issues, while delivering excellent

Qualifications

• High School Diploma or equivalent.
• 3+ years in surgical authorization, insurance verification, or healthcare revenue cycle.
• Proficiency in CPT, ICD-10, HCPCS coding and modifiers.
• Strong knowledge of insurance authorization processes and payer portals.
• Ability to read and interpret medical records and EOBs.
• Excellent organizational and communication skills.

Responsibilities

• Verify insurance eligibility and benefits prior to scheduled surgical services.
• Review, submit, and track surgical authorization and pre-certification requests.
• Communicate with insurance carriers to obtain approvals, authorizations, and referrals.
• Interpret payer policies to confirm medical necessity.
• Calculate and communicate estimated patient financial responsibility.
• Monitor authorization requests through final determination and follow-up.
• Collaborate with clinical staff and revenue cycle teams to resolve issues.
• Document authorization activity in the EMR/EPM system.
• Respond to patient inquiries regarding benefits and costs.
• Maintain compliance with payer requirements and healthcare regulations.
• Manage high volume with accuracy and customer service.

Skills

Insurance verification

Surgical authorization

Medical coding (CPT ICD-10 HCPCS)

Payer portals

Communication skills

Organizational skills

Reading EOBs

EMR/EPM proficiency

Microsoft Office

Attention to detail

Education

High School Diploma

Tools

EMR/EPM systems

Microsoft Office Suite

Job description

ENT Specialty Partners is seeking a Revenue Cycle Specialist II - Surgery Authorization Specialist to support surgical services nationwide. This fully remote role requires expertise in insurance verification, pre-authorizations, and payer communications to ensure timely approvals and accurate patient billing.

You will review benefits, determine medical necessity, document activity in EMR/EPM, and collaborate with clinical teams to resolve complex authorization issues, while delivering excellent