Surgical Authorization Specialist - Conway Medical Center

Education:

• High school diploma required.

Experience

• Previous experience in insurance prior authorization processing required.
• Previous experience working in customer service required.
• A minimum of one (1) year previous experience in a physician’s office and/or experience preferred.
• A minimum of two (2) years’ previous experience working in an office environment preferred.
• Previous experience in surgical scheduling preferred.

Licensure/Certification/Registration

• Certified Medical Assistant (CMA) through an accredited agency preferred.

Duties & Responsibilities:

• Schedule hospital and ASC based surgical/medical procedures for patients with providers according to specific surgical block times according to location, utilizing appropriate scheduling protocols to ensure maximum schedule efficiency.
• Verify insurance benefits, work with insurance companies to submit medical documentation to obtain prior authorizations.
• Interface with appropriate vendor staff to ensure all necessary equipment will be on site for hospital and ASC procedures.
• Interface with appropriate office/ASC/hospital staff to ensure a cohesive working relationship in providing patient care services.
• Enter notes/special instructions needed for scheduling in the electronic medical record system.
• Effectively utilizes clinical knowledge when determining if a medical clearance appointment is consistent with the diagnosis and/or indications indicated by provider and ensures appointments are made for patients and confirms all appointment times with patients via telephone.
• Reviews discharge instructions with patients and ensures proper post-op appointments are scheduled at the time the surgery/procedure is scheduled for after-care follow-up.
• Completes accurate documentation of informed consent with patients for procedures and surgeries as needed.
• Provides accurate, detailed information to patients regarding test preparations, time of patients scheduled arrival, and any other directional information needed; takes appropriate action in responding to questions from patients.
• Responsibilities include updating patient demographic files, assure accurate information is entered in Electronic Medical Records (EMR) as needed.
• Serve as the primary liaison between the patient and their medical team for surgical related questions/concerns.
• Assist/complete other duties as assigned beyond those designated in this primary job description by the Service Line Director, Assistant Director, and Practice Provider.
• Greet all patients and their accompanying family members when applicable and provide exemplary customer service.
• Work effectively and collaboratively with colleagues, physicians, and department heads.
• Effectively utilize strong organizational skills.
• Consistently display effective verbal communication skills.
• Proficient understanding and use of technology/PC skills required.
• Regularly exercise independent judgment in all situations.
• Complete other duties as assigned by department leadership.