Talent.com
Surgery Prior Authorization Specialist
Surgery Prior Authorization SpecialistPEDIATRIC EAR NOSE & THROAT OF ATLANTA PC • Atlanta, GA, US
No longer accepting applications
Surgery Prior Authorization Specialist

Surgery Prior Authorization Specialist

PEDIATRIC EAR NOSE & THROAT OF ATLANTA PC • Atlanta, GA, US
26 days ago
Job type
  • Full-time
Job description

Job Description

Job Description

Job Title : Surgery Prior Authorization Specialist

Location : Atlanta / Sandy Springs, GA

Job Type : Full-Time

About Us :

We are a leading Pediatric Ears, Nose, & Throat practice in Atlanta dedicated to providing exceptional care to our patients. We are currently seeking a skilled and detail-oriented individual to join our team as a Surgery Prior Authorization Specialist.

Job Summary :

The Surgery Prior Authorization Specialist is responsible for managing the prior authorization process for upcoming surgical cases. This role involves ensuring that all authorizations are obtained accurately and in a timely manner, while coordinating closely with physicians, surgical centers, and insurance companies. The ideal candidate will have a strong background in prior authorizations and insurance verification, with a focus on surgery, and will be capable of working in a fast-paced, pediatric ENT setting.

Minimum Qualifications :

  • Minimum one year of experience in prior authorization and insurance verification.
  • Prior experience in Ears, Nose & Throat (ENT) is highly preferred.
  • Familiarity with EMR systems : EPIC and / or ModMed, is highly preferred.
  • Familiarity with insurance processes and authorizations.

Essential Functions :

  • Monitor and manage authorizations for upcoming surgical cases, ensuring timely and accurate approval.
  • Verify patient demographic information and insurance eligibility, including coordination of benefits.
  • Complete surgical cost analysis forms and provide cost estimates for patient collections prior to surgery.
  • Verify insurance benefits for all surgical procedures.
  • Document authorizations and update patient records with authorization progress.
  • Enter authorization information into the case management system.
  • Communicate effectively with physicians, patients, coworkers, hospitals, and surgical centers.
  • Provide ongoing training to staff on new processes to ensure timely surgical case confirmations.
  • Assist surgery schedulers with urgent (STAT) authorizations.
  • Maintain confidentiality of health records and patient information in compliance with HIPAA guidelines.
  • Identify workflow improvement opportunities and work with the department manager to resolve any complaints professionally and promptly.
  • Attend department meetings as required.

    • Skills and Abilities :

  • Strong communication and interpersonal skills.
  • Detail-oriented with excellent organizational abilities.
  • Ability to work both independently and collaboratively.
  • Proficiency with case management software and insurance verification tools.
  • Familiarity with HIPAA compliance and confidentiality standards.
    • Create a job alert for this search

    Prior Authorization Specialist • Atlanta, GA, US