Medical Authorization Specialist – Spine Surgery

🔥 0 minutes ago

🇵🇭 Philippines – Remote

💵 $5 - $7 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

✨ Authorization Specialist

👻 Ghost score 9%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Winning Assistants LLC

WebsiteLinkedInAll Job Openings

51 - 200 employees

💼 Consulting

📣 Marketing

📦 Logistics

Consulting • Marketing • Logistics

Winning Assistants LLC is a staffing and recruiting company that provides virtual assistants from the top 1% of the global talent pool. They specialize in helping doctors, healthcare professionals, and business owners save time, reduce costs, and scale operations with highly skilled, HIPAA-compliant virtual assistants. Their services include admin support, medical office management, marketing, and customer service, allowing clients to focus on growth.

📋 Description

• Manage and process surgery authorizations, particularly for orthopedic and spine procedures • Review authorization requirements and verify insurance information • Submit prior authorization requests through insurance portals • Track authorization requests from submission through determination • Ensure documentation and supporting information are complete and accurate • Follow up on pending authorizations and outstanding requirements • Maintain records of authorization status, reference numbers, correspondence, and next steps • Assist with claims-related and insurance verification tasks • Review denied or rejected authorization requests and identify denial reasons • Prepare and submit insurance appeals • Gather clinical documentation, notes, reports, and supporting records for appeals • Track appeals and follow up within appropriate timelines • Communicate updates and outstanding requirements to internal team members • Navigate multiple insurance portals and research payer-specific requirements • Make outbound calls to insurance companies regarding authorizations, appeals, claims, and documentation • Document calls, reference numbers, decisions, and follow-up requirements • Review procedure and insurance codes • Reference clinical notes and reports through EHR/EMR systems • Prepare reports, spreadsheets, and authorization documentation • Maintain tracking spreadsheets and administrative records • Handle information in accordance with HIPAA and confidentiality requirements

🎯 Requirements

• Previous hands-on surgery authorization experience is required • Previous experience navigating multiple insurance portals is required • Strong understanding of the prior authorization and insurance appeals process is required • Experience communicating directly with insurance companies is required • Experience submitting and tracking authorization requests from start to completion • Experience handling authorization denials and supporting the appeals process • Ability to determine documentation and information required by different insurance companies • Familiarity with insurance and medical procedure codes • Ability to review clinical notes, reports, and supporting medical documentation • Familiarity with EHR/EMR systems such as Epic, Cerner, Athena, or similar platforms • Strong attention to detail and accuracy • Ability to organize and track multiple authorization cases simultaneously • Ability to prioritize tasks based on urgency and authorization timelines • Strong documentation and follow-up skills • Professional communication skills when speaking with insurance representatives • Ability to work independently and consistently follow cases through resolution • Understanding of HIPAA, confidentiality, and accuracy when handling medical and insurance information • Must speak and write English clearly and professionally • Must have relevant work experience • Must provide an NBI Clearance and/or Local Police Clearance before onboarding • Must be available to attend video meetings with camera on when required • Reliable laptop or desktop computer • Stable high-speed internet connection of at least 25 Mbps • Noise-canceling headset • Working webcam • Quiet and professional work environment • Preferred: experience with orthopedic or spine surgery authorizations; familiarity with spine surgery procedure and insurance codes; understanding of workers’ compensation; Epic, Cerner, Athena, Google Workspace/Google Sheets, Microsoft Teams, and previous support of a U.S.-based surgical, orthopedic, spine, or specialty medical practice

🏖️ Benefits

• Dedicated HR & Contractor Support Team • Premium VPN Access (Optional) • HIPAA & Cybersecurity Training + Certification (Provided) • Top 1% VA Performance Training • Client-Approved U.S. Holidays • Client-Approved Paid or Unpaid Time Off; paid time off is optional and only if offered by the client • Access to Tools & Resources, including templates, workflow guides, productivity tools, and client-specific SOP support • Optional performance-based incentives, bonuses, or increased hours based on performance