Surgical Authorization Specialist

🔥 18 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

🤝 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 • Ensure surgery authorizations are obtained accurately and on time • Verify patient demographics, insurance eligibility, and coordination of benefits • Update information needed for claims processing • Complete surgical cost analysis forms and document cost estimates for collection before services • Verify benefits for surgical procedures • Document authorization progress in patient charts and case management • Provide ongoing staff training and education on new processes • Work with the department manager to address and reduce complaints • Assist surgery schedulers with STAT authorizations • Maintain confidentiality of health records and member information in accordance with HIPAA • Identify workflow improvement opportunities • Attend department meetings as required

🎯 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 using Microsoft Excel, Microsoft Word, and Outlook • Ability to multi-task in a fast-paced environment • Detail-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