Strategic Surgical Authorization Specialist

Premier Orthopaedics; Media (Delaware County); On-site; USD 38,000 - 54,000; Full time

Job summary

Premier Orthopaedics and Philadelphia Hand to Shoulder Center are leading providers of musculoskeletal care with locations across PA, NJ and DE. This role supports the surgical authorization workflow, patient eligibility verification, and cost analysis to ensure timely, accurate processing of cases.

The position requires strong organizational skills, effective communication with physicians and patients, and experience with referrals/authorizations in a healthcare setting.

Qualifications

• High school diploma/GED or equivalent working knowledge preferred.
• Minimum of 2 years’ experience in healthcare field is required and previous experience in referrals/authorizations, front office, and/or charge posting is preferred.
• Excellent organizational skills and strong customer service orientation are required with strong background with computers and data entry.
• Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers and other funding sources.
• Federal, state and HIPAA privacy regulations.
• Knowledge of computer applications.

Responsibilities

• Monitors authorizations for upcoming surgical cases on physician calendars.
• Verifies patient demographics and insurance eligibility.
• Completes surgical cost analysis form and documents required cost estimation.
• Verifies benefits on Visco injections.
• Documents authorizations in patient charts and enters information within case management.
• Communicates effectively with physicians, patients, and co-workers to maintain good working relationships.
• Participates in staff training on new processes for timely confirmation of surgical cases.
• Works with department manager to respond to and reduce complaints professionally.
• Assists surgery schedulers with STAT authorizations.

Skills

Effective communication

Customer service

Data entry

Computer literacy

Eligibility verification

Prior authorizations

Education

High school diploma/GED

Tools

Computer applications

Eligibility systems

Job description

Premier Orthopaedics and Philadelphia Hand to Shoulder Center are leading providers of musculoskeletal care with locations across PA, NJ and DE. This role supports the surgical authorization workflow, patient eligibility verification, and cost analysis to ensure timely, accurate processing of cases.

The position requires strong organizational skills, effective communication with physicians and patients, and experience with referrals/authorizations in a healthcare setting.