Authorization Specialist

About Ortho Arizona

At Ortho Arizona, we are bringing the best together. Our organization was created to help serve ALL orthopedic and podiatry needs throughout the Valley! We have a wide range of orthopedic surgeons and mid-level providers including physical and occupational therapists.

Today we are one of Arizona’s largest privately owned and most comprehensive orthopedic practices with more than 75 locally and nationally renowned providers across 30 locations, in addition to 2 ambulatory surgical centers and in‑house state‑of‑the‑art MRI capabilities. At Ortho Arizona we are committed to best‑in‑class patient care, being a pioneer in research and technology, and most importantly, rewarding and recognizing our employees.

• Verify insurance authorization requirements for ordered services/procedures.
• Review documentation or contact the provider when necessary to supplement the order to prove medical necessity.
• Ensure appropriate documentation is available and complete before submitting the authorization to the insurance company to avoid repetitive submissions and denials.
• Submit all authorizations with correct CPT and diagnosis codes.
• Cross‑reference the procedures tasked against the doctor’s orders to ensure all services are submitted correctly.
• Enter any authorization numbers and expiration dates into the EMR for proper claim processing.
• Update pertinent insurance notes in multiple EMR systems for corresponding departments to access.
• Monitor and resolve the status of problem authorizations.
• Fax outgoing imaging orders to corresponding facilities and follow the order to ensure the patient is scheduled.
• Maintain medical records in accordance with practice policies and procedures.
• Estimate prepay amounts due for services and collect co‑insurance, copays, deductibles or estimate self‑pay rates; prepare daily batch, deposits, etc.
• Using state or federally regulated websites may require personal login credentials.

• Excellent customer/patient service. Knowledge of medical terminology.
• Working knowledge of computer programs.
• Excellent written and verbal communication skills.
• Understand/Perform training on practice management software.
• Ability to promote favorable facility image with physicians, patients, insurance companies, and the general public.
• Ability to communicate effectively on the telephone.
• Ability to make decisions and solve problems.
• Working knowledge of health insurance plans including reading plan requirements.
• Follow all Standard Operating Procedures.
• High‑School diploma or GED.
• Minimum of 2 years of experience in healthcare administration or related field.
• Strong organizational and communication skills.
• Ability to work independently and as part of a team.
• Knowledge of medical terminology and insurance authorization processes.

• Robust paid time off package including sick time, holidays, and paid time off.
• Medical with multiple different plan options.
• Health Savings account + company contributions.
• Dental & Vision Insurance.
• Company‑paid life insurance policy + the option to purchase additional benefits to protect you from what life throws at you.
• 401(k) with a company contribution + profit sharing.
• Pet Discount Plan.
• Protection & Legal Assistance.

Entry level

Full‑time

Other

Medical Practices