What are the responsibilities and job description for the Lead Surgical Authorization position at HOPCo?
The CORE Institute team is dedicated to making the lives of others better by practicing exceptional patient care. If you would like to be part of a dedicated, dynamic healthcare team in a challenging, rewarding environment, The CORE Institute is the right place for you to grow your career.
The CORE Institute delivers integrated, comprehensive musculoskeletal and neurological care. The CORE Institute is built upon a foundation of pioneering research, academics, community service, and a passion for excellence in patient care. The organization continues to be a leader in payor-reform initiatives, and it is at the forefront of systems-based quality programs which drive value and improve the quality of patient care.
As The CORE Institute continues to grow, we are looking for a Surgical Authorizations Lead in our Corporate Headquarters. Please see below for the functions and requirements for this position.
ESSENTIAL FUNCTIONS
- Monitors the authorizations of upcoming surgical cases, ensuring authorizations for surgeries are obtained in a timely and accurate manner.
- Verifies patient insurance eligibility and 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.
- Ensure the daily tasks of the department are worked on and submitted promptly and accurately.
- Monitors the productivity and performance of department staff, including reporting daily/weekly/monthly department metrics to leadership.
- Assists with researching and resolving authorization discrepancies in a timely manner.
- Establishes and maintains effective communication and collaboration with other departments within the organization.
- Works with sensitive and confidential materials and must be able to exercise discretion.
- Other duties as assigned by department leadership.
EDUCATION
- High school diploma/GED or equivalent working knowledge preferred.
EXPERIENCE
- Minimum two years of experience in the healthcare field is required
- Previous surgical authorizations experience is preferred.
REQUIREMENTS
- Must be able to communicate effectively with physicians, patients, and the public.
- Capable of establishing good working relationships with both internal and external customers.
KNOWLEDGE
- Knowledge of medical and surgical terminology.
- Knowledge of computer programs and applications.
- Hospital surgery scheduling experience is desirable.
SKILLS
- Skill in customer service and an understanding of HOPCo’s AEIOU’s code of conduct and culture.
- Skill in communicating effectively with physicians, clinical staff, and the public.
- Skill in establishing good working relationships with both internal and external customers.
- Excellent organizational skills and strong customer service orientation are required with a strong background in computers and data entry.
ABILITIES
- Ability to follow oral and written instructions.
- Ability to establish professional working relationships with providers, staff, and the public.
- Ability to scan materials into the correct patient chart.
ENVIRONMENTAL WORKING CONDITIONS
- Normal office environment.
PHYSICAL/MENTAL DEMANDS
- Requires sitting and standing associated with a normal office environment.
- Some bending and stretching are required.
- Manual dexterity using a calculator and computer keyboard
