Surgical Authorization Specialist

🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Healthcare Outcomes Performance Co. (HOPCo)

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

🤝 B2B

☁️ SaaS

💰 Private equity on 2019-02

Healthcare • B2B • SaaS

Healthcare Outcomes Performance Co. (HOPCo) is the largest orthopedic value-based care organization in the U. S. , specializing in comprehensive musculoskeletal (MSK) care delivery, management, and value creation. Led by orthopedic physicians and executives, HOPCo operates an accredited MSK clinically integrated network and offers practice partnership and health system solutions, payor-facing population health and value-based care programs, analytics and outcomes reporting, and digital patient engagement tools to align stakeholders, improve outcomes, and lower total MSK costs.

📋 Description

• Monitor authorizations for upcoming surgical cases on physicians’ calendars, ensuring surgery authorizations are obtained timely and accurately • Verify patient demographic information and insurance eligibility, including coordination of benefits • Update and confirm information needed to process claims to insurance plans • Complete surgical cost analysis forms and document surgical cost estimates for collection before services • Verify benefits on all surgical procedures • Document authorizations and authorization progress in patient charts • Enter authorization information in case management • Communicate effectively with physicians, patients, and coworkers and establish good working relationships with internal and external customers • Provide ongoing staff training and education on new processes to ensure timely confirmation of surgical cases • Work with the department manager to respond to and reduce complaints in a timely and professional manner • Assist surgery schedulers with STAT authorizations • Maintain strict confidentiality of health records and member information and follow 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 and benefits verification • Working knowledge of prior authorizations from HMOs, PPOs, commercial payers, and other funding sources • Ability to communicate effectively with physicians, patients, and coworkers • Ability to establish good working relationships with internal and external customers • Ability to maintain strict confidentiality of health records and member information • Ability to 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