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Surgical Authorization Specialist presso Hopco

Hopco · Phoenix, Stati Uniti d'America · Onsite

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Benefits:

  • 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.

 

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