Surgery Authorization Specialist

Job Description

Job DescriptionDescription:

We are looking for a full-time Surgery Authorization Specialist to join our top notch team of professionals!

Position will be located at our Woodforest office.

Woodforest: 750 Fish Creek Thoroughfare Montgomery, TX 77316

Previous experience with orthopedics is preferred but not required

Hours:

8:00 AM to 5:00 PM or 8:30 AM to 5:30 PM with rotating Saturdays (every 6-8 weeks from 8:00 AM to 12:15 PM)

Job Summary:

• Responsible for all aspects of insurance verification and authorizations. Primary focus on Surgery Authorizations, VISCO injections. DME and MRI obtaining benefits, getting authorizations, and scheduling patients.

Essential Duties:

• Responds promptly to patient and staff needs.
• Verify insurance eligibility, benefits, and pre-authorization/pre-certification via telephone and internet.
• Initiate the process of obtaining prior authorization, if required, to maximize the opportunity for reimbursement.
• Update patient information as needed in Athena.
• Participates in facility committees, meetings, in-services, and activities.
• Compliant with HIPAA, OSHA, state and federal regulation, and company policies and procedures.
• Perform other miscellaneous office/clerical duties as needed.

Requirements:

Education and Qualifications:

• High School Diploma or GED certificate.
• Graduate of a certified medical office training course preferred
• Basic knowledge of ICD-10 coding and CPT codes
• 2 years’ experience surgery authorization process required.
• Knowledge of EMRs, Athena preferred.