Surgical Authorization Specialist

🔥 20 hours ago

🌵 Arizona – Remote

🌵 Arizona – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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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Healthcare Outcomes Performance Co. (HOPCo)

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

☁️ SaaS

🤝 B2B

💰 Private equity on 2019-02

Healthcare • SaaS • B2B

Healthcare Outcomes Performance Company (HOPCo) is the largest orthopedic musculoskeletal (MSK) value-based care organization in the U. S. It is physician-led and provides comprehensive MSK care delivery and management services: advanced practice management, health system MSK service-line optimization and market transformation, payor solutions, and practice partnerships. HOPCo operates a URAC-accredited MSK clinically integrated network, runs population health and value-based care programs, and offers digital patient engagement, outcomes reporting, and analytics platforms to align stakeholders, improve outcomes, and reduce total cost of MSK care.

📋 Description

• Monitor authorizations for upcoming surgical cases on physicians’ calendars • Ensure surgery authorizations are obtained accurately and on time • Verify patient demographic information and insurance eligibility, including coordination of benefits • Update and confirm information needed for claims processing • Complete surgical cost analysis forms and document required cost estimates for collection before services • Verify benefits for all surgical procedures • Document authorization status and progress in patient charts and case management • Provide ongoing staff training and education regarding new processes • Work with the department manager to respond to and reduce complaints • Assist surgery schedulers with STAT authorizations • Identify opportunities to improve daily workflow processes • Attend department meetings as required • Communicate with physicians, patients, coworkers, management, providers, and internal and external customers

🎯 Requirements

• High school diploma/GED or equivalent working knowledge preferred • Minimum of 2 years of experience in the healthcare field required • Previous experience in referrals/authorizations, front office, and/or charge posting preferred • Excellent organizational skills and strong customer service orientation required • 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 • Knowledge of federal, state, and HIPAA privacy regulations • Knowledge of computer applications • Skill in effective organization and billing requirements and authorization processes • Skill in Microsoft Excel, Microsoft Word, and Outlook • Ability to multi-task in a fast-paced environment • Detailed oriented with strong organizational skills • Ability to understand patient demographic information and determine insurance eligibility • Ability to work independently and analyze data • Ability to communicate effectively and compassionately with patients, co-workers, management, and providers • Must meet HIPAA guidelines and maintain strict confidentiality of health records and member information

🏖️ Benefits

• Full-Time employment • Remote work arrangement