Surgical Authorization Specialist
About The Position
Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is seeking a meticulous and knowledgeable Surgical Authorization Specialist to join our team in ou r Paoli, Collegeville and Exton PA locations . As two of the region's most respected providers of orthopedic and upper extremity care, we offer a collaborative, patient-focused environment that prioritizes clinical excellence, innovation, and ongoing professional development. The Surgical Authorization Specialist is a vital member of the Authorizations department, responsible for obtaining insurance authorizations, verifying patient eligibility and benefits, and completing cost estimates for surgical procedures. This role ensures that all financial and administrative prerequisites for surgery are met accurately and in a timely manner, supporting a seamless patient experience and efficient clinic workflow. This is a full-time position on-site .
Requirements
- High school diploma/GED or equivalent working knowledge preferred.
- A minimum of 2 years of experience in the healthcare field is required.
- Experience working with eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, and commercial payers.
- Experience using computer applications, including Microsoft Office Suite, and accurately entering data into practice management systems and EMRs.
Nice To Haves
- Previous experience in referrals/authorizations, front office operations, or charge posting is preferred.
Responsibilities
- Monitor physician surgical calendars to ensure authorizations are obtained accurately and in a timely manner for all upcoming cases.
- Verify patient demographic information and insurance eligibility, including coordination of benefits.
- Complete surgical cost analysis forms to document required cost estimations for collection prior to services.
- Verify benefits for all scheduled surgical procedures.
- Accurately document authorization details and progress within the patient's electronic medical record (EMR) and case management system.
- Communicate effectively with physicians, patients, co-workers, and insurance representatives to establish good working relationships.
- Assist surgery schedulers with STAT or urgent authorization requests as needed.
- Ensure strict confidentiality of all health records and patient information in compliance with HIPAA guidelines.
- Assist in identifying opportunities for improvement within the daily authorization workflow process.
- Perform other duties as assigned.
Benefits
- Comprehensive benefits package including medical, dental, and vision plans
- 100% employer-paid life insurance
- 401(k) retirement plan with employer Safe Harbor contribution and additional discretionary profit sharing
- Benefits are effective on your hire date (for full-time employees)
- Generous paid sick and vacation time
- 7 paid holidays annually
- Opportunities for growth and advancement
- Employee referral reward program
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
501-1,000 employees
