Surgery Prior Authorization Specialist
PEDIATRIC EAR NOSE & THROAT OF ATLANTA PCAtlanta, GA, US30+ days ago
Job type
- Full-time
Job descriptionMonitor 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. 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.
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 :
Skills and Abilities :
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Prior Authorization Specialist • Atlanta, GA, US
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