Procedure Authorization Specialist- Full time

Benefits

• Competitive Health & Welfare Benefits
• HSA with qualifying HDHP plans with company match
• 401k plan after 6 months of service with company match (Part-time employees included)
• Employee Assistance Program that is available 24/7 to provide support
• Employee Appreciation Days
• Employee Wellness Events

Minimum Qualifications

• Two years of experience in the healthcare field is required with previous call center experience is preferred.
• Minimum one year in Prior Auth and or Insurance verification
• Preferred: Experience in Spinal Cord, Kyphoplasty and Imaging highly preferred

Essential Functions

• Maintains authorizations of upcoming surgical cases on the physician’s calendars ensuring timely and accurate authorizations for surgeries.
• Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans.
• Accurately completes surgical cost analysis form, documenting the required surgical cost estimation for collection prior to services.
• Verifies benefits on all surgical procedures.
• Documents the authorizations and progress of authorizations in the patient’s chart.
• Enters the authorization information within case management.
• Communicates effectively with physicians, patients, and co-workers and establishes good working relationships with both internal and external customers.
• Participates in providing ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases.
• Responds to and reduces complaints timely and professionally.
• Assists surgery schedulers with STAT authorizations.
• Safeguards strict confidentiality of all health records, member information and meets HIPAA guidelines.
• Identifies opportunities for improvement within the daily workflow process.
• Attends department meetings as required.

About Us

The Center for Orthopedic Research and Education, We don't mean to brag but did you know The CORE Institute has been ranked by Ranking Arizona: The Best of Arizona Businesses!? #1 for Orthopedic Practices #1 for Healthiest Healthcare Employers #3 for Best Healthcare Workplace Culture