Surgery Authorization and Insurance Benefits Specialist

This is a remote position. The surgery authorization and benefits specialist acquires and verifies patient benefits for scheduled surgical procedures, determines when a prior authorization is pertinent and secures it, and handles the payer and patient calls that these items involve. Because this work carries real “intricacies,” the practice is looking for someone who understands surgical benefits and authorizations, knows when a prior authorization is required, communicates clearly with patients, and becomes a dependable, long-term fit for the team rather than another turnover.

Key Responsibilities

●Acquire and verify insurance benefits and eligibility for patients whose surgical procedures are being scheduled, and break down those benefits clearly for each case. ●Call patients to explain their benefits for an upcoming surgery, including what is covered in-network and out-of-network. ●Determine when a prior authorization is pertinent for a scheduled surgical procedure, and obtain the prior authorizations and surgical clearances the payer requires.

●Obtain and review payer fee schedules tied to each procedure and its reimbursement. ●Work payer portals and phone lines, including Availity and UHC, and, as the practice puts it, when the information is not online, “pick up the phone and call.” ●Handle the calls that these benefits and authorization items involve, with both payers and patients.

●Document benefits, authorization, and clearance activity in Dr. Chrono (the clinic EMR) and HST (the surgery center system). ●Communicate with patients by phone in clear, easily understood English, with the patience and professionalism suited to an older patient population. ●Occasionally schedule a surgery when the need arises.

●Work within the practice’s developing structure and training guides for benefits and authorizations. Systems and Tools The assistant works in the following systems, accessed through Help. Squad’s secure Microsoft virtual desktop: ●Dr. Chrono, the practice’s podiatry-specific EMR ●HST, used for the surgery center ●Availity and UHC payer portals for verification and authorizations ●Weave AI soft phone for patient and payer calls, rolling out over the coming weeks Requirements What We Are Looking For ●Clear, patient-understandable English comes first.

The assistant must speak and write English clearly, with a neutral accent that patients can easily understand, because clear communication with patients is the practice’s number one priority. ●Hands-on experience with surgical authorizations and insurance benefits, including the judgment to know when a prior authorization is required for a procedure.

●A solid understanding of in-network and out-of-network benefits, which is required for this role. ●Comfort working payer portals and making payer calls to resolve benefits, eligibility, and authorization questions. ●Strong listening skills, close attention to detail, and a warm, professional manner with patients. ●Willingness to learn practice-specific terminology and workflows, and to grow into a long-term fit for the team.

●Reliability and professionalism in a HIPAA-regulated environment.

Benefits

Competitive hourly rate On-time payments, every time Payments processed via Wise Training & Support Direct client training provided — you are never thrown in blind Dedicated Account Manager as your point of contact Stable, long-term placement with a growing U.S.-based company Exposure to a wide range of modern SaaS platforms Potential for increased responsibilities as the company scales Tenure recognition for long-term team members Clear escalation paths — you always know who to go to Work Environment 100% remote — work from home U.

S.-based company with structured operations Stable, long-term account placements (not gig-style work) Supportive team culture across all accounts Growth & Experience Build your U.S. industry experience Exposure to multiple practice types and platforms Potential for increased hours or additional accounts based on performance Strengthen your resume with verified, legitimate U.

S. client experience Recognition Tenure recognition for long-term team members We value loyalty and recognize those who grow with us