Job Description
Job Description
Company Overview
Flagstaff Surgical Associates (FSA) is a busy multi-specialty medical clinic serving Northern Arizona. Our services include General Surgery, Gastroenterology, Urology, ENT, Audiology, and Allergy care. FSA prides itself on compassionate patient care and delivering high-quality healthcare.
Position Overview
The Prior Authorizations Specialist is responsible for obtaining authorizations for surgeries, in-office procedures, and other medical services performed within FSA practices. The PA Specialist will obtain patient benefits in a timely and professional fashion.
Primary Responsibilities
Authorization Review & Verification:
- Verify insurance benefits and eligibility for all scheduled surgeries and in-office procedures.
- Review each procedure to determine if prior authorization is required based on payer guidelines and internal protocols.
- Maintain accurate documentation of all authorization requirements and outcomes in the patient record.
Authorization Processing:
- Initiate authorization requests by completing required forms and compiling supporting clinical documentation.
- Submit authorization packets to insurance payers, facilities, or third-party partners as appropriate.
- Monitor all pending authorizations and follow up to ensure approvals are received prior to the date of service.
- Confirm no procedure requiring authorization is performed without documented approval.
Collaboration & Workflow Support:
- Work closely with physicians, clinical staff, schedulers, and the billing team to resolve authorization discrepancies or obtain missing information.
- Communicate changes in payer rules, requirements, or workflow updates to schedulers and relevant staff in a timely manner.
- Collaborate with appropriate staff members on authorization corrections or resubmissions.
- Answer and make prior authorization related phone calls in a timely and professional manner.
- Check and return voicemails daily to ensure timely follow-up and communication.
- Maintain organized documentation to support accuracy and continuity of care.
- Perform additional administrative or clinical support tasks as assigned by management.
Compliance:
- Ensure compliance with HIPAA regulations.
- Maintain patient confidentiality and accurate medical documentation.
Knowledge, Skills, and Qualifications:
- Must have High School Diploma or equivalent.
- Prior insurance and billing experience recommended.
- Exceptional verbal and written communication skills.
- Exceptional organizational skills.
- High standards of professionalism.
Benefits & Compensation:
- 100% employer-paid Medical & Dental (Aetna; starts after 60 days)
- Vision Insurance (VSP - voluntary)
- HSA, HCFSA & DCFSA options
- $25,000 Life Insurance (employer-paid)
- Long-Term Disability coverage
- Commuter benefits
- Voluntary benefits (pet, life, accident, legal, and more)
- 128 hours PTO annually
-
401(k) after 1 year with 5% match