Surgery Prior Authorization Specialist

Position Overview:
We are seeking a detail-oriented and organized Part-Time Surgery Prior Authorization Specialist to join our podiatry practice. The specialist will be responsible for obtaining and managing the necessary prior authorizations for surgical procedures performed by our podiatrist. This role requires a strong understanding of insurance processes, medical terminology, and the ability to effectively communicate with both patients and insurance providers.

Key Responsibilities:

• Prior Authorization Management: Submit, track, and follow up on prior authorization requests for surgical procedures, ensuring that all documentation and required forms are complete and accurate.
• Insurance Verification: Verify insurance coverage and benefits for surgery procedures and determine pre-authorization requirements.
• Patient Communication: Communicate with patients regarding insurance coverage and surgery-related authorizations, answering questions, and providing guidance through the process.
• Documentation and Record Keeping: Maintain accurate and up-to-date records of all authorization requests, approvals, and denials in the practice's system.
• Collaboration: Work closely with the podiatrist, office staff, and insurance companies to resolve any issues or discrepancies related to prior authorization.
• Denial Management: Handle denials and appeals, working with both the insurance company and the practice’s clinical staff to obtain approval for necessary surgical procedures.
• Compliance: Ensure all authorization processes comply with insurance company guidelines and industry standards.
• General Office Support: Provide additional administrative support to the practice as needed, including filing, organizing patient information, and assisting with scheduling when necessary.
• Other Duties as assigned

Qualifications:

• Experience: Minimum of 2 years in medical billing and/or prior authorization, preferably within podiatry or similar healthcare settings.
• Knowledge: Strong understanding of insurance policies, prior authorization processes, and medical terminology.
• Skills: Excellent communication and customer service skills, both written and verbal. Strong attention to detail and organizational abilities.
• Technology: Proficient in using electronic medical record (EMR) systems, Microsoft Office Suite, and other medical billing software.
• Education: High school diploma or equivalent required. Medical billing/coding certification (e.g., CPC or similar) is a plus.

Work Schedule:

• Part-time, flexible hours (approx. 20-25 hours per week)

Job Type: Part-time

Pay: From $16.00 per hour

Expected hours: 20 – 25 per week

Work Location: In person

Salary : $16