Surgical Authorization Specialist- REMOTE (Must live in AZ Time zone)

May 27, 2026

ESSENTIAL FUNCTIONS <ul> <li>Monitors the authorizations of upcoming surgical cases on the physician’s calendars ensuring authorizations for surgeries are obtained in a timely and accurate manner.</li> <li>Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms necessary information to allow processing of claims to insurance plans.</li> <li>Accurately completes surgical cost analysis form, documenting the required surgical cost estimation for collection prior to services.</li> <li>Verifies benefits on all surgical procedures.</li> <li>Document authorizations and progress of authorizations in the patient’s chart. Enters the authorization information within case management.</li> <li>Must be able to communicate effectively with physicians, patients, and co-workers and be capable of establishing good working relationships with both internal and external customers.</li> <li>Participate in providing ongoing training and education of staff as it relates to new processes to ensure timely confirmation of surgical cases.</li> <li>Work with department manager to respond to and reduce complaints timely and professionally.</li> <li>Assist surgery schedulers with STAT authorizations.</li> <li>Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines.</li> <li>Assists in identifying opportunities for improvement within the daily workflow process.</li> <li>Attends department meetings as required.</li> </ul> EDUCATION <ul> <li>High school diploma/GED or equivalent working knowledge preferred.</li> </ul> EXPERIENCE <ul> <li>A minimum of 2 years of experience in the healthcare field is required and previous experience in referrals/authorizations, front office, and/or charge posting is preferred.</li> <li>Excellent organizational skills and strong customer service orientation are required with a strong background in computers and data entry.</li> </ul> KNOWLEDGE <ul> <li>Working knowledge of eligibility, verification of benefits, and prior authorizations from various HMOs, PPOs, commercial payers, and other funding sources.</li> <li>Federal, state, and HIPAA privacy regulations.</li> <li>Knowledge of computer applications.</li> </ul> SKILLS <ul> <li>Skill in effective organization and billing requirements and authorization processes.</li> <li>Skill in using computer programs and applications including Microsoft Excel, Microsoft Word, and Outlook</li> <li>Skill in establishing good working relationships with both internal and external customers.</li> </ul> ABILITIES <ul> <li>Ability to multi-task in a fast-paced environment. Must be detailed oriented with strong organizational skills.</li> <li>Ability to understand patient demographic information and determine insurance eligibility.</li> <li>Ability to work independently and demonstrate the ability to analyze data.</li> <li>Ability to communicate effectively and compassionately with patients, co-workers, management, and providers.</li> </ul> ENVIRONMENTAL WORKING CONDITIONS <ul> <li>Normal office environment.</li> </ul> PHYSICAL/MENTAL DEMANDS <ul> <li>Requires sitting and standing associated with a normal office environment.</li> <li>Some bending and stretching are required.</li> <li>Manual dexterity using a calculator and computer keyboard</li> </ul> ORGANIZATIONAL REQUIREMENTS <ul> <li>HOPCo Mission, Vision, and Values must be read and signed.</li> </ul> This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.

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