Surgery Preauthorization & Scheduling Specialist

Wheaton Eye Clinic LTD; Wheaton (IL); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical

Group Life and LTD

Paid Time Off

Paid Holidays

Clothing Allowance

Vision Care Benefits

Voluntary Benefit Offerings - Life,STD

Job summary

Wheaton Eye Clinic LTD in Wheaton, IL is seeking a Surgical Precertification Specialist to obtain preauthorization for outpatient surgeries and coordinate with insurance providers.

The role requires strong communication, organization, and multitasking in a busy ophthalmology office. Expect daytime hours Monday through Friday, with responsibilities spanning authorizations, denials handling, and coordination with physicians and facilities.

Qualifications

• Education: High school graduate or equivalent.
• Ability to read, write and speak in a clear and professional manner required.
• Knowledge of ICD-10 required.
• 1–2 years insurance experience with knowledge of prior authorization processes preferred.
• 1–2 years medical scheduling experience preferred.
• General knowledge regarding medical terminology preferred.

Responsibilities

• Contact insurance companies, HMO providers and/or local unions to initiate preauthorization for all outpatient surgeries.
• Communicate with primary care physicians and utilization management organizations to obtain surgery authorizations for HMO patients; submit clinical information.
• Follow up with requests to ensure timely responses and avoid last-minute cancellations.
• In event of a denial, communicate the decision with the surgeon, patient, facility and scheduling staff.
• Investigate denials and submit appeals with assistance from providers.
• Obtain authorizations for urgent add-on surgeries promptly.
• Respond to inquiries by telephone and written correspondence with quality customer service.
• Respond to requests for additional information from insurance companies, case managers, and primary care offices.
• Communicate with surgical facilities regarding preauthorization status.
• Provide accurate, thorough and timely documentation of all information pertinent to patient treatment.
• Assist with Surgery Scheduling tasks: answer calls, schedule appointments, coordinate preoperative testing.

Skills

Strong communication

Customer service

Organizational skills

Multitasking

Education

High school diploma or equivalent

Tools

EMR/EHR systems

Billing software

Job description

Wheaton Eye Clinic LTD in Wheaton, IL is seeking a Surgical Precertification Specialist to obtain preauthorization for outpatient surgeries and coordinate with insurance providers.

The role requires strong communication, organization, and multitasking in a busy ophthalmology office. Expect daytime hours Monday through Friday, with responsibilities spanning authorizations, denials handling, and coordination with physicians and facilities.