What are the responsibilities and job description for the Surgical Authorization Specialist position at The CORE Institute | HOPCo?
Benefits:
- Starting at $19.00
- Competitive Health & Welfare Benefits
- Monthly $43 stipend to use toward ancillary 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 Wellness Events
Minimum Qualifications:
- A minimum of 2 years of experience in the healthcare field is required and previous experience in referrals/authorizations, front office, and/or charge posting is preferred.
- Excellent organizational skills and strong customer service orientation are required with a strong background in computers and data entry.
- Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers, and other funding sources.
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.
- 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 the department manager to respond to and reduce complaints timely and professional.
- 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.
Salary : $43
