Surgery Authorization Specialist

Socket.dev; Spring (TX); Hybrid; USD 42,000 - 66,000; Full time

Job summary

Socket.dev in Spring, TX is seeking a full-time Surgery Authorization Specialist to join our team. The role focuses on insurance verification, prior authorizations, and scheduling for surgical procedures and VISCO injections.

The position offers a hybrid work arrangement with on-site option at Spring and remote work. You will work with EMR systems (Athena) and ensure HIPAA compliance while coordinating with patients and providers.

Qualifications

• High School Diploma or GED required.
• Graduate of a certified medical office training course preferred.
• Basic knowledge of ICD-10 and CPT codes is needed.
• 2 years’ experience in surgery authorization process required.
• Knowledge of EMRs, Athena preferred.

Responsibilities

• Responsible for all aspects of insurance verification and authorizations, focusing on Surgery Authorizations and VISCO injections.
• Verify insurance eligibility, benefits, and pre-authorization via phone/internet.
• Initiate prior authorization processes to maximize reimbursement opportunities.
• Update patient information in Athena as needed.
• Participate in facility committees, meetings, and trainings.
• Comply with HIPAA, OSHA, and state/federal regulations and company policies.
• Perform other office/clerical duties as needed.

Skills

Insurance verification

Authorization processing

Scheduling

HIPAA compliance

EMR systems

Education

High School Diploma or GED

Certified medical office training course

Tools

Athena EMR

ICD-10 coding

CPT coding

Job description

Description

We are looking for a full-time Surgery Authorization Specialist to join our top notch team of professionals!

Position will be located either at our Spring office or remote.

Spring: 20639 Kuykendahl Rd, Spring, TX 77379

Previous experience with orthopedics is preferred but not required

Hours:

8:00 AM to 5:00 PM or 8:30 AM to 5:30 PM with rotating Saturdays (every 6-8 weeks from 8:00 AM to 12:15 PM)

Job Summary:

• Responsible for all aspects of insurance verification and authorizations. Primary focus on Surgery Authorizations, VISCO injections. DME and MRI obtaining benefits, getting authorizations, and scheduling patients.

Essential Duties:

• Responds promptly to patient and staff needs.
• Verify insurance eligibility, benefits, and pre-authorization/pre-certification via telephone and internet.
• Initiate the process of obtaining prior authorization, if required, to maximize the opportunity for reimbursement.
• Update patient information as needed in Athena.
• Participates in facility committees, meetings, in-services, and activities.
• Compliant with HIPAA, OSHA, state and federal regulation, and company policies and procedures.
• Perform other miscellaneous office/clerical duties as needed.

Requirements

Education and Qualifications:

• High School Diploma or GED certificate.
• Graduate of a certified medical office training course preferred
• Basic knowledge of ICD-10 coding and CPT codes
• 2 years’ experience surgery authorization process required.
• Knowledge of EMRs, Athena preferred.