Surgical Authorization Specialist

🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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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 of upcoming surgical cases on physician calendars, ensuring surgeries are authorized in a timely and accurate manner • Verify patient demographic information and insurance eligibility, including coordination of benefits • Update and confirm information needed to process claims with insurance plans • Complete surgical cost analysis forms and document required surgical cost estimates for collection before services • Verify benefits on all surgical procedures • Document authorizations and authorization progress in patient charts • Enter authorization information within case management • Communicate effectively with physicians, patients, and co-workers and establish good working relationships with internal and external customers • Participate in ongoing staff training and education regarding new processes • Work with the department manager to respond to and reduce complaints promptly and professionally • Assist surgery schedulers with STAT authorizations • Maintain strict confidentiality of health records and member information and comply with HIPAA guidelines • Identify opportunities to improve daily workflow processes • Attend department meetings as required

🎯 Requirements

• Minimum 2 years of experience in the healthcare field • Previous experience in referrals/authorizations, front office, and/or charge posting preferred • Excellent organizational skills • Strong customer service orientation • Strong computer and data-entry background • Working knowledge of eligibility, verification of benefits, and prior authorizations • Experience with HMOs, PPOs, commercial payers, and other funding sources • Effective communication with physicians, patients, and co-workers • Ability to establish good working relationships with internal and external customers • Ability to maintain strict confidentiality of health records and member information • Must meet HIPAA guidelines

🏖️ Benefits

• 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