Surgical Navigator ASC

FLSA Status: Non-Exempt (Full-Time)

Work Location: Remote

Position Summary

The Surgical Navigator serves as the centralized coordinator for ASC surgical/procedural scheduling, physician order management, payer medical necessity review, prior authorization/precertification, medical clearance coordination, financial clearance, patient scheduling and registration in SIS, and procedural order management within AthenaOne. This role ensures every procedure is clinically, financially, and operationally ready prior to the date of service while serving as the primary liaison between providers, patients, ASC staff, and payers.

Essential Responsibilities

• Review and validate physician procedure orders.

• Ensure complete documentation supports medical necessity.

• Review payer-specific coverage, LCD/NCD, and commercial policies.

• Obtain prior authorizations, precertification's, referrals, and notifications.

• Coordinate peer-to-peer reviews and appeals when needed.

• Coordinate all required medical clearances (PCP, cardiology, pulmonary, labs, EKGs, imaging, anticoagulation, etc.).

• Verify insurance eligibility and benefits.

• Conduct patient financial clearance and discuss estimated responsibility.

• Schedule and register patients accurately in SIS.

• Manage procedure orders and workflow within AthenaOne.

• Maintain worklists and documentation through completion.

• Coordinate with providers, anesthesia, vendors, and ASC leadership.

• Educate patients regarding procedure preparation and financial expectations.

• Maintain compliance with CMS, payer, HIPAA, and accreditation requirements.

Key Performance Indicators

• ≥98% Authorization Accuracy

• ≥95% Financial Clearance Prior to Procedure

• ≥98% Registration Accuracy

• ≥95% Medical Clearance Completion Prior to Surgery

• <3% Same-Day Cancellations Related to Authorization/Clearance

• 100% AthenaOne Documentation Compliance

• High Patient Satisfaction Scores

Required Qualifications

• High school diploma required; Associate's or Bachelor's degree preferred.

• Three or more years of ASC, surgery scheduling, authorization, or procedural coordination experience.

• Knowledge of Medicare, Medicaid, and commercial payer requirements.

• Experience with CPT, ICD-10-CM, HCPCS, AthenaOne, and/or SIS preferred.

• Excellent organizational, communication, and customer service skills.

Equal Employment Opportunity

We are an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, pregnancy, national origin, age, disability, genetic information, veteran status, sexual orientation, gender identity, or any other status protected by applicable law.

This job description describes the general duties and responsibilities of the position. It is not intended to be an exhaustive list of all responsibilities, skills, or working conditions. Responsibilities may be modified based on organizational and patient-care needs.