Surgery Scheduler & Prior Authorization Specialist

Surgery Scheduler & Prior Authorization Specialist Carolina Retina Institute Cary, NC Job Details Part-time | Full-time From $22 an hour 1 hour ago Benefits 401(k) Paid time off Qualifications Health insurance authorizations Insurance prior authorization Overseeing health insurance pre-certification Medicare Medical insurance coverage verification Health insurance information Medical office experience Outpatient Medical coding in outpatient clinics Medical scheduling Insurance medical billing Attention to detail Health insurance pre-authorization requirements Clinical documentation Medical billing Computer skills Full Job Description Job Description We are a private Ophthalmology practice deeply committed to excellence in patient care and are looking for a team member who will share our passion for excellence. We currently have an opening for about 32 hours a week for a Surgery Scheduler/ Prior Authorization Specialist in our Cary office. The candidate needs to have atleast 2 years of experience with getting Prior Authorizations for requested In-Office procedures, Injections and Outpatient Surgeries. They need to understand the Medical Benefits of Medicare and commercial health insurance.

Essential Functions:

Schedules hospital-based surgeries with different hospitals with high accuracy of time and location. Ensures patients have proper medical clearance and pre-surgical testing as needed. Goes over all consent forms, discusses the types of lenses, payment options and collects payment. Completes accurate informed consent documentation with patients for procedures and surgeries as needed. Serve as a primary point of contact for patients, guiding them through treatment plans, insurance processes, and financial assistance options for Injections, Procedures and Surgeries Verify insurance eligibility and benefit details for injectable medications and procedures Obtain all necessary prior authorizations for retina injections, ensuring accurate ICD-10, CPT, and HCPCS coding. Submit supporting clinical documentation, including notes, diagnostics, and test results, to facilitate approvals Respond to patient and clinic inquiries regarding billing, coverage, and assistance programs Knowledgeable regarding co-management with referring providers and ensures compliance with the scheduling of post-operative visits. Communicates with referring providers as needed Must have ability to work under pressure and deadlines, last minute changes and multitask. Must be Fluent in computer systems and work independently as well as directly with provider team and patients. Assists other members of the front desk team as needed. Other duties as assigned. Performs all above-mentioned tasks by paying attention to detail and providing excellent customer service skills with Patients, Physicians and other related members Maintains positive attitude consisting of cooperation, self-motivation, courtesy, and professionalism. Complies with company compliance policies and standards. Qualifications 2+ years of proven experience in a medical office setting with familiarity in surgical coordination or clinic administration. Strong knowledge of insurance verification, prior authorizations and specialty drug coverage - ophthalmology experience strongly preferred Strong knowledge of EMR systems including EYEMD, OPTIVATE or similar platforms. Proficiency in medical coding (CPT, ICD-10/ICD-9), billing procedures, insurance verification, and documentation review. Excellent organizational skills with the ability to manage multiple schedules simultaneously while maintaining attention to detail. Exceptional communication skills—bilingual abilities are a plus—and outstanding phone etiquette.

Pay:

From $22.00 per hour

Benefits:

401(k) Paid time off Application Question(s): This job is for 30 hours a week; does that work for you or do you need to work 40 hours I need the staff in the office by 7.50 am ready to be seeing patients at 8. Are you able to be in office on time. Are you able to reliabily commute to the office ? How far do you live from the office ?

Experience:

Prior Authorization:

1 year (Required) health insurance verification: 1 year (Required) Medical billing: 1 year (Preferred)

Work Location:

In person