Surgical Precertification & Authorization Specialist

Bridgeview Eye Partners; Cuyahoga Falls (OH); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Paid holidays

PTO after 60 days

Health, dental, vision benefits

401k plan

Certification program advancement

Job summary

Davis Eye Center is seeking a detail-oriented Surgical Services Precertification Specialist to ensure timely, authorized surgical care. You will secure prior authorizations, verify coverage, and coordinate with surgeons, schedulers, clinics, and patients to obtain approvals before procedures.

Join a collaborative surgical services team focused on patient confidentiality, high-quality care, and streamlined workflows in a professional medical office setting.

Qualifications

• High school diploma or equivalent; associate degree preferred.
• Experience with insurance verification, prior authorizations, medical billing, or healthcare administration.
• Knowledge of CPT, ICD-10, and insurance processes.
• Strong attention to detail and organizational skills.
• Ability to prioritize multiple tasks in a fast-paced environment.
• Excellent verbal and written communication skills.
• Proficiency with EMR and Microsoft Office applications.
• Ability to work independently while collaborating with cross-functional teams.

Responsibilities

• Obtain insurance prior authorizations and precertifications for surgical procedures.
• Verify insurance benefits, eligibility, and coverage requirements.
• Review clinical documentation to ensure authorization requirements are met.
• Communicate with insurance carriers regarding authorization status and appeals.
• Coordinate with surgeons, surgery schedulers, clinics, and patients to obtain approvals before surgery.
• Maintain documentation in the electronic medical record and other systems.
• Monitor authorization expiration dates and renewals as needed.
• Resolve authorization denials and assist with appeals as appropriate.
• Stay current on payer guidelines, authorization requirements, and regulatory changes.
• Provide exceptional customer service while maintaining patient confidentiality and HIPAA compliance.

Skills

Insurance verification

Prior authorizations

Medical billing

Healthcare administration

HIPAA compliance

Attention to detail

Organizational skills

Verbal and written communication

Education

High school diploma or equivalent

Associate degree preferred

Tools

Electronic medical records

Microsoft Office

Job description

Davis Eye Center is seeking a detail-oriented Surgical Services Precertification Specialist to ensure timely, authorized surgical care. You will secure prior authorizations, verify coverage, and coordinate with surgeons, schedulers, clinics, and patients to obtain approvals before procedures.

Join a collaborative surgical services team focused on patient confidentiality, high-quality care, and streamlined workflows in a professional medical office setting.