Medical Office Biller & Surgical Authorizations Coordinator

Job Summary:

The Medical Office Biller & Surgical Authorizations Coordinator is responsible for managing the billing process and securing pre-authorizations for thoracic surgical procedures. The position serves as a liaison between the clinical team, patients, and insurance companies to facilitate smooth surgical scheduling and financial clearance.

Key Responsibilities:

Billing & Coding Duties:

• Review medical records and operative reports to assign appropriate ICD-10, CPT, and HCPCS codes.
• Coordinates with CBO on billing issues and denied claims
• Work with patients on billing inquiries, payment plans, and insurance issues.

Surgical Authorizations & Scheduling Support:

• Obtain prior authorizations for all thoracic surgeries, diagnostic imaging (e.g., CT, PET scans), and procedures (e.g., bronchoscopy, biopsy).
• Communicate with insurance companies to verify patient benefits and coverage.
• Coordinate with the surgical scheduler and clinical staff to ensure authorization requirements are met before surgery dates.
• Track and document authorization status, follow up on pending requests, and escalate issues when needed.
• Ensure documentation meets payer requirements to minimize risk of denial.
• Maintain accurate and organized records of all authorizations and related correspondence.

Required Qualifications:

• High school diploma or equivalent; associate degree or certification in medical billing/coding preferred.
• Minimum 2 years of experience in medical billing and surgical authorization, preferably in a specialty practice (thoracic, cardiothoracic, oncology, or surgical practice ideal).
• Certified Professional Coder (CPC) or Certified Coding Associate (CCA) is a plus.
• Working knowledge of CPT, ICD-10, and insurance billing guidelines.
• Experience with prior authorization portals and payer-specific processes.
• Proficient in EMR and practice management systems – Cerner, Intergy, and Medaptus
• Strong understanding of Medicare, Medicaid, and commercial insurance requirements.

Skills and Competencies:

• Attention to detail and accuracy in coding and data entry.
• Excellent communication and problem-solving skills.
• Ability to manage multiple tasks and meet deadlines.
• Knowledge of HIPAA and patient confidentiality regulations.
• Ability to work independently and as part of a multidisciplinary team.