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

Requirements

• 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

Miscellaneous

• 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.

Current Openings for Prior Authorization Specialist Surgery Jobs at Oregon Urology Institute