Surgery Authorization RepPrint

Job Summary

Proliance Orthopaedics and Sports Medicine, a division of Proliance Surgeons, Inc., currently is seeking a Surgery Authorization Rep.

Job Description

Posted: 03/02/2020
Status: Full Time
Type: Administrative
City: Issaquah, WA

Our busy Orthopaedic practice is seeking a motivated self-directed hard working individual to manage all duties relating to authorization for surgeries.  

Duties and Responsibilities:

  • Reviews and comprehends patient progress notes, lab reports, imaging reports, and plan of care Identifies appropriate medical documentation that satisfies payer medical policy criteria
  • Interacts professionally and effectively with clinicians, patients, and insurance companies
    • Effectively coordinates Peer to Peer discussions between Clinicians and Insurance companies
  • Follows-up with patients in the case of denied coverage of a surgery. Provides superior customer service to all patients, works through patient-raised issues, and recommends appropriate solutions
  • Verifies insurance eligibility and benefits, utilizing automated eligibility systems, payer portals, or telephone communication
  • Maintains organized, detailed summaries of prior authorization requests to support post-claim denial workflows.

Skills Strongly Preferred

  • Effective communication skills
  • Ability to work in high volume patient environment
  • Strong attention to detail
  • Self-directed/Motivated
  • Working knowledge of medical terminology, abbreviations and anatomy
  • Experience verifying insurance utilizing online portals
  • 1 year experience in referral coordination required
  • Next Gen AND Epic experience preferred


Apply Now

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