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    Surgical Authorization Specialist - Phoenix, United States - Center for Orthopedic and Research Excel

    Center for Orthopedic and Research Excel
    Center for Orthopedic and Research Excel Phoenix, United States

    1 week ago

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    Description

    Job Description

    Job Description

    Benefits:

    • Starting at $19.00
    • Competitive Health & Welfare Benefits
    • Monthly $43 stipend to use toward ancillary 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 Wellness Events

    Minimum Qualifications:

    • A minimum of 2 years of experience in the healthcare field is required and previous experience in referrals/authorizations, front office, and/or charge posting is preferred.
    • Excellent organizational skills and strong customer service orientation are required with a strong background in computers and data entry.
    • Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers, and other funding sources.

    Essential Functions

    • Monitors the authorizations of upcoming surgical cases on the physician's calendars ensuring authorizations for surgeries are obtained in a timely and accurate manner.
    • Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans.
    • completes surgical cost analysis form, documenting the required surgical cost estimation for collection prior to services.
    • Verifies benefits on all surgical procedures.
    • Document authorizations and progress of authorizations in the patient's chart. Enters the authorization information within case management.
    • Must be able to communicate effectively with physicians, patients, and co-workers and be capable of establishing good working relationships with both internal and external customers.
    • Participate in providing ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases.
    • Work with the department manager to respond to and reduce complaints timely and professional.
    • Assist surgery schedulers with STAT authorizations.
    • Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines.
    • Assists in identifying opportunities for improvement within the daily workflow process.
    • Attends department meetings as required.
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