We are seeking a highly motivated and detail-oriented individual to join our dynamic healthcare team as an
Orthopedic/Spine Preauthorization Specialist. In this position, you will play a crucial role in ensuring exceptional patient care, and efficient reimbursement within our Preauthorization Department. You will be responsible for reviewing and processing preauthorization requests for Orthopedic, Imaging, Surgery, Pain Management, and Spine procedures as well as Durable Medical Equipment, and PT while working closely with our surgery schedulers, healthcare providers, insurance companies, and patients to ensure timely approvals.
Key Responsibilities:
Review and evaluate preauthorization requests for orthopedic procedures and treatments, ensuring completeness and accuracy of documentation.
Verify patient insurance coverage and eligibility for requested services.
Collaborate with clinical staff to gather necessary medical records and supporting documentation.
Communicate effectively with insurance companies to obtain preauthorization approvals
Maintain accurate and up-to-date records of preauthorization requests, approvals, and denials status.
Educate healthcare providers on preauthorization requirements and assist in resolving any preauthorization related issues or concerns.
Stay updated on insurance industry regulations, policies, and guidelines related to orthopedic preauthorization.
Required Skills & Qualifications:
1+ years’ experience in prior authorizations, insurance verification, utilization review, or medical billing — experience in orthopedics, spine, or pain management preferred.
High school diploma or GED required; healthcare-related certificate or associate degree preferred.
Strong knowledge of orthopedic procedures, treatments, and medical terminology.
Familiarity with payer portals, EMRs (e.g., Athena, Availity Humana Military, etc), and CPT/ICD-10 basics
Attention to detail and ability to analyze complex medical documentation.
Strong communication skills, both written and verbal, with the ability to effectively interact with healthcare professionals, insurance companies, and patients.
Proficient computer skills, including experience with electronic medical record (EMR) systems
Ability to work independently and as part of a team, managing multiple priorities and meeting deadlines in a fast-paced environment.
Commitment to maintaining patient confidentiality and adhering to HIPAA guidelines.
Professional phone etiquette and ability to work under deadlines.
Bilingual skills a plus (Spanish/ASL).
What We Offer:
Competitive salary (DOE)
Medical, dental, and vision benefits
Paid time off and holiday pay
401(k) or retirement plan options
Supportive team environment and opportunities for growth
How to Apply: Send your resume and brief cover letter to [email protected] with the subject line “Preauthorization Specialist — [Your Name]”.
All Job Ads are subject to GrabJobs’s Terms of Service. We allow users to flag postings that may be in violation of those terms. Job Ads may also be flagged by GrabJobs moderation team. However, no moderation system is perfect, and flagging a posting does not ensure that it will be removed.
Be the first to receive the latest Others Full-Time Jobs in the US.
Setup your job alert:
By activating job alerts, I agree to GrabJobs Terms & Privacy Policy. I can unsubscribe to job alerts anytime.
Skip
GrabJobs is the no1 job portal in the US, connecting you to thousands of jobs fast!
Find the best jobs in the US, apply in 1 click and get a job today!
Your email job alert is now active!