What are the responsibilities and job description for the Procedure Authorization Specialist- Full time position at The CORE Institute?
Benefits:
- Competitive Health & Welfare 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 Appreciation Days
- Employee Wellness Events
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
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.
About us:
The Center for Orthopedic Research and Education, We don't mean to brag but did you know The CORE Institute has been ranked by Ranking Arizona: The Best of Arizona Businesses!?
- #1 for Orthopedic Practices
- #1 for Healthiest Healthcare Employers
- #3 for Best Healthcare Workplace Culture