What are the responsibilities and job description for the Surgery Authorization Specialist position at Sterling Ridge Orthopaedics & Sports Medicine?
Job Summary:
- Responsible for all aspects of insurance verification and authorizations. Primary focus on Surgery Authorizations, VISCO injections, DME, and MRI obtaining benefits, getting authorizations, and scheduling patients.
Key Responsibilities:
- Verify insurance eligibility, benefits, and pre-authorization/pre-certification via telephone and internet.
- Initiate the process of obtaining prior authorization, if required, to maximize the opportunity for reimbursement.
- Update patient information as needed in Athena.
- Participate in facility committees, meetings, in-services, and activities.
- Compliant with HIPAA, OSHA, state and federal regulations, and company policies and procedures.
- Perform other miscellaneous office/clerical duties as needed.
Requirements:
- High School Diploma or GED certificate.
- Graduate of a certified medical office training course preferred.
- BASIC KNOWLEDGE OF ICD-10 CODING AND CPT CODES
- 2 years' experience in the surgery authorization process required.
- Knowledge of EMRs, Athena preferred.
Work Schedule:
- Full-time position.
- Hours: 8:00 AM to 5:00 PM or 8:30 AM to 5:30 PM with rotating Saturdays (every 6-8 weeks from 8:00 AM to 12:15 PM).
