Surgical Authorization Specialist

Healthcare Outcomes Performance Company
Phoenix, AZ Full Time
POSTED ON 7/6/2022 CLOSED ON 6/6/2023

Job Posting for Surgical Authorization Specialist at Healthcare Outcomes Performance Company

Healthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.

As HOPCo continues to grow, we are looking for a Surgical Authorization Specialist in our Corporate Headquarters. Please see below for the functions and requirements to be a Surgical Authorization Specialist with HOPCo.

ESSENTIAL FUNCTIONS

  • Monitors the authorizations of upcoming surgical cases, pain procedures and imaging on the physician’s calendars, physician’s templates and CISH Schedule ensuring authorizations are obtained in a timely and accurate manor.
  • 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 cost analysis form, documenting the required cost estimation for collection prior to services.
  • Verifies benefits on all surgical procedures, pain procedures and in office procedures
  • Document’s 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 facilities. 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 department manager to respond to and reduce complaints timely and professionally.
  • Assist surgery schedulers and procedure schedulers with STAT authorizations.
  • Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines.
  • Assists in identifying opportunity for improvement within daily work flow process.
  • Attends department meetings as required.

EDUCATION

  • High school diploma/GED or equivalent working knowledge preferred

EXPERIENCE

  • Minimum of 2 years’ experience in 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 strong background with computers and data entry.

#HOP

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