Authorization Coordinator

Job Summary:

The Authorization Coordinator at Progressive Spine & Orthopaedics plays a crucial role in ensuring that all necessary authorizations for surgeries are obtained efficiently and accurately within a timely manner. This position involves working closely with the Surgical Coordinator and Team Lead to secure authorizations from various entities, including out-of-network insurances, workers' compensation, etc.

Responsibilities:

• Obtaining all authorizations for surgery from out-of-network insurances, worker's comp, etc.
• Request documentation needed from patients and attorneys to submit with authorizations.
• Ensure all necessary information is submitted accurately and timely to avoid delays in surgery scheduling.
• Communicate effectively with the Surgical Coordinator, Team Lead, and surgical facilities' staff regarding authorization status and requirements.
• Maintain detailed records of all authorization requests and follow-ups.
• Resolve any authorization-related issues or denials.
• Respond timely to all phone calls and emails from patients, physicians, co-workers, insurance companies, hospitals and firms.
• Document all account activity, updating patient information in EMR, etc.
• Request, follow-up and secure prior-authorizations prior to services being performed.
• Verify all necessary information and record information in patient's medical record regarding surgery and any surgical related patient needs.
• Available to answer physician, patient, adn staff questions regarding patient's upcoming surgeries.
• Keep up-to-date with changes in insurance requirements and authorization processes.
• Other duties as assigned.

Qualifications:

• High school diploma or equivalent; additional education or certification in healthcare administration is a plus.
• Proven experience working in a similar role, preferably in a healthcare setting.
• Strong understanding of authorization processes for surgery, including health insurance and workers' compensation.
• Excellent communication and organizational skills.
• Ability to work effectively in a fast-paced environment and prioritize tasks.
• Proficiency in computer skills, including MS Office applications.
• Knowledge of medical terminology and orthopaedic procedures is a plus.