Oregon Urology Institute

Prior Authorization Specialist Surgery Jobs at Oregon Urology Institute

Prior Authorization Specialist Surgery Jobs at Oregon Urology Institute

Sample Prior Authorization Specialist Surgery Job Description

Prior Authorization Specialist - Surgery

Oregon Urology Institute has an opening for a full time Prior Authorization Specialist (Surgery)

Position Overview

Responsible to obtain all required authorizations prior to a surgery or other OUI service being performed, includes verification of patient insurance coverage, benefit levels, out of pocket responsibilities and correcting denied claims

Essential Job Functions

  • Verify insurance coverage for scheduled surgery patients
  • Verify coverage levels for each specific patient surgery
  • Review all scheduled surgeries for needed authorizations
  • Contact insurance carriers to obtain necessary surgery authorizations prior to surgery
  • Notify patients of deposit requirements and follow-up as necessary
  • Work closely with surgery schedulers, coders and clinical staff to ensure authorizations are obtained for all surgeries
  • Work closely with other members of the Authorization/Referral team to ensure Office visit authorizations are in place prior to Surgery
  • Review and take corrective action on denied claims
  • Responsible to ensure that reimbursement exceeds cost of supplies (implants, etc.) for all surgeries and/or procedures done within OUI and OSC
  • Obtain Authorization for outside test or procedures as needed
  • Perform other duties as assigned by Department Lead or Manager


  • Prior experience working in a related role in a medical office or other health care related organization
  • Knowledge of CPT and ICD10 coding
  • Knowledge of insurance coverages and reimbursement practices
  • Strong verbal and written communication skills
  • Strong computer skills
  • Ability to work both independently and as a member of a team
  • Ability to remain organized and detail oriented while working at a fast pace


  • Candidate must pass a drug screen and background check to obtain employment
  • Covid vaccination required

Competitive benefit package.

All interested applicants will need to complete our online employment application.

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