Surgery Prior Authorization Coordinator

Position Overview Responsible to obtain all required authorizations prior to a surgery being performed, includes verification of patient insurance coverage, benefit levels and out of pocket responsibilities Essential Job Functions – Verify insurance coverage for scheduled surgery patients – Verify coverage levels for each specific patient surgery – Review all scheduled surgeries for needed authorizations – Contact insurance carriers to obtain necessary surgery authorizations prior to surgery – Notify patients of deposit requirements and follow-up as necessary – Work closely with surgery schedulers, coders and clinical staff to ensure authorizations are obtained for all surgeries – Review and take corrective action on denied claims – Responsible to ensure that reimbursement exceeds cost of supplies (implants, etc.) for all surgeries and/or procedures done within OUI and OSC – Perform other duties as assigned by Department Lead or Manager Requirements – Prior experience working in a related role in a medical office or other health care related organization – Knowledge of CPT and ICD 9/10 coding – Knowledge of insurance coverages and reimbursement practices – Strong verbal and written communication skills – Strong computer skills – Ability to work both independently and as a member of a team – Ability to remain organized and detail oriented while working at a fast pace