Surgical Prior Authorization Pro

Pain Institute of Southern Arizona; Tucson (AZ); On-site; USD 42,000 - 54,000; Full time

Job summary

Pain Institute of Southern Arizona is seeking a Surgical Prior Authorization Specialist to obtain pre-authorizations from insurance carriers and input data accurately into the EMR. The role involves coordinating with scheduling staff, patients, and providers to ensure timely approvals and scheduling.

The ideal candidate has at least one year of prior authorization experience in healthcare, strong knowledge of CPT/ICD-10, and proficient use of EMR systems and insurance portals.

Qualifications

• Minimum one-year experience with prior authorization in healthcare.
• Knowledge of CPT, ICD-10, NCCI edits and LCD policies.
• Proficient with EMR systems and insurance portals.
• Excellent verbal and written communication skills.
• Understanding of authorization procedure workflow.
• Understanding of HIPAA regulations and patient confidentiality.

Responsibilities

• Obtain prior authorizations from insurance carriers.
• Input data accurately into the EMR system.
• Review surgical schedules to identify payors needing prior authorization.
• Communicate with scheduling coordinators when authorization is obtained and patient is ready to be scheduled.
• Inform patients and providers about denials and next steps.
• Follow up on all denials and document communications with insurers.
• Perform light administrative duties as assigned.

Skills

Prior authorization experience

Medical terminology

CPT/ICD-10 knowledge

EMR software

Insurance portals

Communication skills

HIPAA compliance

Patient confidentiality

Data analysis

Multitasking

Tools

Excel

EMR software

Job description

Pain Institute of Southern Arizona is seeking a Surgical Prior Authorization Specialist to obtain pre-authorizations from insurance carriers and input data accurately into the EMR. The role involves coordinating with scheduling staff, patients, and providers to ensure timely approvals and scheduling.

The ideal candidate has at least one year of prior authorization experience in healthcare, strong knowledge of CPT/ICD-10, and proficient use of EMR systems and insurance portals.