Spine Surgery Authorization Specialist

Winning Assistants; United States; On-site; USD 7,164,000 - 14,327,000; Full time

Job summary

Winning Assistants is seeking an experienced Medical Authorization Specialist (Spine Surgery) to support a U.S.-based spine care practice. The role involves processing surgical authorizations, handling insurance portals, and managing appeals with accuracy and HIPAA compliance.

You will work in a non-patient-facing capacity, coordinating with insurance providers, reviewing clinical documentation, and ensuring timely authorization determinations and denials follow-up.

Qualifications

• Hands-on surgery authorization experience required.
• Experience navigating multiple insurance portals required.
• Strong understanding of prior authorization and appeals process.
• Experience communicating with insurance companies required.
• Able to submit and track authorizations from start to finish.
• Familiar with spine/orthopedic procedure codes and HIPAA rules.

Responsibilities

• Manage and process surgery authorizations for spine/orthopedic procedures.
• Verify insurance information and submit prior authorization requests.
• Track authorizations from submission to determination and follow up.
• Assist with insurance appeals and denial management with documentation.
• Navigate payer portals and communicate with insurers to obtain updates.
• Review clinical notes and codes in EHR/EMR systems to support requests.

Skills

Surgery authorization experience

Insurance portals navigation

Communication with insurers

Denials & appeals process

HIPAA compliance

EHR/EMR familiarity

Tools

Epic

Cerner

Athena

Google Workspace

Microsoft Teams

Job description

Winning Assistants is seeking an experienced Medical Authorization Specialist (Spine Surgery) to support a U.S.-based spine care practice. The role involves processing surgical authorizations, handling insurance portals, and managing appeals with accuracy and HIPAA compliance.

You will work in a non-patient-facing capacity, coordinating with insurance providers, reviewing clinical documentation, and ensuring timely authorization determinations and denials follow-up.