Surgery Authorization Specialist

Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise.

Center for Bone & Joint Surgery of the Palm Beaches is seeking a Surgery Authorization Specialist to obtaining authorizations, verifying eligibility and coordination of benefits and obtaining a cost estimate for surgical procedures.

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.
  
  
  

EDUCATION

• High school diploma/GED or equivalent working knowledge preferred.
  
  
  

Experience

• A minimum of 2 years of experience in the healthcare field is required and previous experience in referrals/authorizations,
  
  
  

front office, and/or charge posting is preferred.

• Excellent organizational skills and strong customer service orientation are required with a strong background in computers
  
  
  

and data entry.

KNOWLEDGE

• Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial
  
  
  

payers, and other funding sources.

At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package 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 with company match
• Employee Assistance Program that is available 24/7 to provide support
• Paid Time Off
• Paid Holidays
• and more...
  
  
  

#CBJ

#CBJ