A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
Atlas Neurosurgery and Spine CenterSurgery Scheduler / Prior Authorization Specialist Reports to:
Practice Manager Hours:
Monday-Friday, 8:00 a.m.-4:30 p.m. or 8:30 a.m.-5:00 p.m. Overview The Surgery Scheduler / Prior Authorization Specialist is responsible for coordinating and scheduling surgical procedures in a fast-paced healthcare environment. This role serves as a key liaison between patients, surgeons, pre-operative clearance providers, operating rooms, nerve monitoring teams, anesthesia teams, vendors, attorneys, and insurance providers. The ideal candidate is highly organized, detail-oriented, proactive, and able to manage multiple priorities while ensuring procedures are scheduled accurately, efficiently, and in compliance with clinical, insurance, and administrative requirements. This position plays an important role in supporting efficient clinical operations and providing a positive, patient-centered experience. Duties and Responsibilities Answer surgery-related phone calls and provide professional, courteous assistance to patients and other customers. Process surgery-related emails, faxes, and text messages in a timely manner. Obtain and confirm prior authorizations from insurance companies. Ensure all required pre-operative clearances are completed well in advance of scheduled surgery dates. Provide vendors with real-time updates regarding upcoming surgical cases. Schedule all lien patients and provide final surgery estimates to attorneys and paralegals. Notify the billing department of STAT surgery add-ons, cancellations, and case reschedules. Ensure all surgical cases are accurately documented in the EMR and current tracking system. Schedule all ICA surgery patients and obtain authorizations for braces and transportation, when indicated. Review medical records, clinical documentation, and provider notes to ensure completeness and accuracy for prior authorization and billing purposes. Communicate with patients regarding surgery details, insurance requirements, pre-operative requirements, and instructions by phone or electronic messaging. Maintain accurate documentation of scheduling activities, authorization statuses, and correspondence. Protect patient confidentiality by safeguarding medical, personal, and financial information in accordance with HIPAA requirements. Collaborate with surgeons, clinical staff, facilities, and other members of the care team to ensure all pre-operative requirements are completed before surgery. Provide professional and courteous assistance to patients, healthcare providers, facilities, vendors, and other customers. Perform other duties as assigned by the Practice Manager. Qualifications and Skills Prior surgery scheduling experience required. Experience with prior authorizations, insurance verification, and medical billing processes. Strong understanding of insurance requirements and prior authorization procedures. Proficiency with electronic medical record (EMR) systems. Ability to work efficiently within multiple systems and applications simultaneously. Proficiency with Microsoft Office, Google Workspace, and similar productivity applications. Strong organizational skills with exceptional attention to detail. Ability to multitask, prioritize responsibilities, and manage time effectively in a fast-paced environment. Ability to review complex medical records and clinical documentation for accuracy and completeness. Excellent written and verbal communication skills. Excellent customer service and interpersonal skills. Knowledge of HIPAA requirements and the ability to maintain patient confidentiality at all times. Join Atlas Neurosurgery and Spine Center and help ensure a smooth surgical experience for our patients while supporting our providers and clinical team through accurate, efficient, and compassionate coordination of care.
Pay:
$20.00 - $26.00 per hour
Benefits:
401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance