Surgical Authorization Specialist

SURGICAL AUTHORIZATION SPECIALIST

Established in 2001, Southeast Orthopedic Specialists is a regional leader in orthopedic medicine. We are dedicated to growing with our patients. Our reach will continue to expand to meet the needs of all patients, present and future. It is our wish to make industry-leading five-star orthopedic care accessible to as many people as possible.

At Southeast Orthopedic Specialists, we are dedicated to taking care of you so you can take care of business! We offer our Full-Time Employees a robust BENEFITS PACKAGE that includes the following:

• 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
• Employee Assistance Program available 24/7
• Employee Appreciation Days/Events
• Paid Time Off & Paid Holidays
• AND MORE!

Minimum Qualifications:

• Two years of experience in the healthcare field is required with previous call center experience is preferred.
• Minimum one year in Prior Auth and or Insurance verification
• Experience with Vein Authorization highly preferred

Preferred: Experience in Spinal Cord, Kyphoplasty and Imaging highly preferred

Essential Functions

• Monitors the authorizations of upcoming surgical cases on the physician’s calendars ensuring authorizations for surgeries are obtained in a timely and accurate manner.
• Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans.
• Accurately completes surgical cost analysis form, documenting the required surgical cost estimation for collection prior to services.
• Verifies benefits on all surgical procedures.
• Document authorizations and progress of authorizations in the patient’s chart. Enters the authorization information within case management.
• Must be able to communicate effectively with physicians, patients, and co-workers and be capable of establishing good working relationships with both internal and external customers.
• Participate in providing ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases.
• Work with department manager to respond to and reduce complaints timely and professionally.
• Assist surgery schedulers with STAT authorizations.
• Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines.
• Assists in identifying opportunities for improvement within the daily workflow process.
• Attends department meetings as required.