Prior Authorization Specialist

Summit Brain, Spine and Orthopedics is a busy neurosurgery and orthopedic practice in Lehi, Utah. We are looking for a full-time prior authorization specialist to join our team of all-star employees. If you have experience working in a medical office, we would love to hear from you. This position is responsible for operational tasks through the full cycle of prior authorization and surgery scheduling. The mission of the prior authorization specialist is to provide excellent patient care, be a team player, and perform a wide variety of office duties with a smile!

RESPONSIBILITIES:

• Provide amazing patient care!
• Identify which facility is in-network for the patient and verify insurance benefits.
• Communicate with surgery scheduling team to choose a surgery date.
• Gather documents to submit surgery authorization to insurance carriers.
• Monitor closely that we have the documentation needed to get an approval.
• Correctly choose the CPT codes and surgical diagnosis for recommended surgery.
• Communicate with patients the status of their authorization.
• Document status of authorization from submitted to pending to approved.
• Appeal denials.
• Answer questions from the office staff, patients, providers.
• Send referrals and imaging orders per provider request​.
• Maintain patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPPA).
• Perform other related duties or special projects as assigned.

NECESSARY SKILLS & ABILITIES:

• 1 years of coding experience (certified coders preferred).
• Experience with PM & EHR software.
• Handle multiple tasks simultaneously.
• Communicate kindly and efficiently with all levels of staff.
• Maintain composure while working under high pressure.
• Demonstrate strong interpersonal skills that foster a positive environment.
• Demonstrate flexibility and ability to adapt to change.
• Excellent communication, time management, and computer skills.
• Must be accurate with attention to detail.
• Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections.
• A calm manner and patience working with either patients, insurers, or co-workers throughout the process.

Job Type: Full-time

Pay: $25.00 - $27.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off

Work Location: In person

Salary : $25 - $27