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 timely and accurate authorization • Verify patient demographics, insurance eligibility, and coordination of benefits • Complete surgical cost analysis forms and document required cost estimates for collection before services • Verify benefits for all surgical procedures • Document authorization progress in patient charts and enter authorization information into case management • Provide ongoing staff training and education on new processes • Work with the department manager to respond to and reduce complaints • Assist surgery schedulers with STAT authorizations • Maintain confidentiality of health records and member information in accordance with HIPAA • Identify opportunities to improve daily workflow processes • Attend department meetings as required

🎯 Requirements

• High school diploma/GED or equivalent working knowledge is 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 • Strong computer and data-entry background • Working knowledge of eligibility, benefits verification, and prior authorizations for HMOs, PPOs, commercial payers, and other funding sources • Knowledge of federal, state, and HIPAA privacy regulations • Knowledge of computer applications • Effective organization and billing requirements and authorization processes • Proficiency with Microsoft Excel, Microsoft Word, and Outlook • Ability to multitask in a fast-paced environment and maintain strong attention to detail • 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, coworkers, management, and providers