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

🤝 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 of 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 with insurance plans • Complete surgical cost analysis forms and document required surgical cost estimates for collection before services • Verify benefits for all surgical procedures • Document authorizations and authorization progress in patient charts • Enter authorization information in case management • Communicate effectively with physicians, patients, coworkers, and 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 timely 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 required • Previous experience in referrals/authorizations, front office, and/or charge posting preferred • Excellent organizational skills required • Strong customer service orientation required • Strong computer and data entry background required • Working knowledge of eligibility verification, benefits verification, and prior authorizations • Experience working with 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 • Knowledge of and compliance with 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