Surgical Authorization Specialist

The CORE Institute; Phoenix (AZ); On-site; USD 42,000 - 66,000; Full time

Benefits offered by this job

Monthly $43 stipend toward ancillary –

HSA with qualifying HDHP plans with 公司

401k plan after 6 months of service с

Employee Assistance Program that is 24

Employee Wellness Events

Job summary

The CORE Institute is seeking an experienced Authorization Specialist in Phoenix, AZ to manage surgical case authorizations, verify eligibility, and coordinate benefits with payers. You will work closely with physicians, patients, and staff to ensure timely approvals and accurate documentation.

Ideal candidates have 2+ years in healthcare, familiarity with referrals and prior authorizations, strong data entry skills, and excellent organizational and customer service abilities.

Qualifications

• Minimum of 2 years of experience in healthcare.
• Experience in referrals/authorizations, front office, and/or charge posting preferred.
• Excellent organizational and customer service skills; strong background in computers and data entry.
• Knowledge of eligibility, verification of benefits, and prior authorizations from various payers.

Responsibilities

• Monitor upcoming surgical case authorizations to ensure timely approvals.
• Verify patient demographics and insurance eligibility, including coordination of benefits.
• Complete surgical cost analysis and document estimates prior to services.
• Verify benefits on all surgical procedures and document authorizations in the chart.
• Communicate effectively with physicians, patients, and coworkers; build strong working relationships with internal and external customers.
• Participate in training staff on new processes to ensure timely confirmation of surgical cases.
• Assist department manager in responding to and reducing complaints promptly and professionally.
• Assist surgery schedulers with STAT authorizations.
• Maintain strict confidentiality of health records and HIPAA compliance.
• Attend department meetings as required.

Skills

Healthcare experience

Referrals/authorizations

Front office

Charge posting

Organization skills

Customer service

Data entry

Computers

HIPAA knowledge

Job description

• Monthly $43 stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan after 6 months of service with company match (Part-time employees included)
• Employee Assistance Program that is available 24/7 to provide support
• Employee Wellness Events

Minimum Qualifications:

• A minimum of 2 years of experience in the 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 a strong background in computers and data entry.
• Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers, and other funding sources.

Essential Functions

• Monitors the authorizations of upcoming surgical cases on the physician’s calendars ensuring authorizations for surgeries are obtained in a timely and accurate manner.
• Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans.
• completes surgical cost analysis form, documenting the required surgical cost estimation for collection prior to services.
• Verifies benefits on all surgical procedures.
• Document authorizations and progress of authorizations in the patient’s chart. Enters the authorization information within case management.
• Must be able to communicate effectively with physicians, patients, and co-workers and be capable of establishing good working relationships with both internal and external customers.
• Participate in providing ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases.
• Work with the department manager to respond to and reduce complaints timely and professional.
• Assist surgery schedulers with STAT authorizations.
• Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines.
• Assists in identifying opportunities for improvement within the daily workflow process.
• Attends department meetings as required.

Equal Opportunity Employer
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