Surgical Prior Authorization Pro — Patient Care & Compliance

OrthoArizona; Chandler (AZ); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Robust paid time off

Medical with multiple plan options

Health Savings Account (HSA)

Dental & Vision Insurance

401(k)

Pet Discount Plan

ID Theft Protection & Legal Assistance

Job summary

OrthoArizona is seeking a Prior Authorization Specialist to join our Chandler, AZ team. You will verify insurance authorization requirements for procedures, review documentation, and submit accurate authorizations with CPT/diagnosis codes to prove medical necessity.

You will enter authorization numbers into the EMR, monitor status, and coordinate with physicians and insurers to minimize denials while maintaining patient care standards.

Qualifications

• Excellent customer service and patient-facing skills.
• Working knowledge of medical terminology.
• Excellent written and verbal communication skills.
• Understanding/training on practice management software.
• Ability to promote a positive facility image with physicians, patients, insurers and the public.
• Strong organizational and communication skills.
• Ability to work independently and in a team.
• Knowledge of health insurance plans and authorization processes.

Responsibilities

• Verify insurance authorization requirements for ordered services/procedures.
• Review documentation or contact providers to supplement orders for medical necessity.
• Ensure documentation is complete before submitting authorization to insurers.
• Submit authorizations with correct CPT and diagnosis codes.
• Cross-reference procedures with doctor orders to ensure correct submissions.
• Enter authorization numbers and expiration dates into the EMR.
• Update insurance notes in EMR for access by relevant departments.
• Monitor and resolve status of problem authorizations.
• Fax imaging orders and ensure patient scheduling.
• Maintain medical records per policies and procedures.
• Estimate prepay amounts and collect co-insurance, copays, deductibles, or self-pay estimates.

Skills

Customer service

Communication

Problem solving

Medical terminology

Teamwork

Education

High School diploma or GED

Tools

EMR systems

Job description

OrthoArizona is seeking a Prior Authorization Specialist to join our Chandler, AZ team. You will verify insurance authorization requirements for procedures, review documentation, and submit accurate authorizations with CPT/diagnosis codes to prove medical necessity.

You will enter authorization numbers into the EMR, monitor status, and coordinate with physicians and insurers to minimize denials while maintaining patient care standards.