Surgery Authorization Specialist

Healthcare Outcomes Performance Co. (HOPCo)

West Palm Beach, FL

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JOB DETAILS

SKILLS

Case Management, Claims Processing, Communication Skills, Cost Analysis, Cost Estimates, Customer Support/Service, Data Entry, Disease Treatment, Documentation, Funding, HIPAA (Health Insurance Portability and Accountability Act), Health Maintenance Organization (HMO), Healthcare, High School Diploma, Insurance Claims, Medical Records, Organizational Skills, Orthopedic Surgery, Patient Confidentiality, Preferred Provider Organization (PPO), Staff Training, Surgical Procedures, Time Management, Training/Teaching

LOCATION

West Palm Beach, FL

POSTED

1 day ago

Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise.

Center for Bone & Joint Surgery of the Palm Beaches is seeking a Surgery Authorization Specialist to obtaining authorizations, verifying eligibility and coordination of benefits and obtaining a cost estimate for surgical procedures.

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.
• Accurately 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 department manager to respond to and reduce complaints timely and professionally.
• 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.

EDUCATION
• High school diploma/GED or equivalent working knowledge preferred.

EXPERIENCE
• 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.

KNOWLEDGE
• Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial
payers, and other funding sources.

At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:

Competitive Health & Welfare Benefits
Monthly $43 stipend to use toward ancillary benefits
HSA with qualifying HDHP plans with company match
401k plan with company match
Employee Assistance Program that is available 24/7 to provide support
Paid Time Off
Paid Holidays
and more...

#CBJ

#CBJ

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

About the Company

Healthcare Outcomes Performance Co. (HOPCo)

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