Surgery Scheduler and Prior Authorization Specialist
Surgery Scheduler and Prior Authorization Specialist
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1 Vacancy
Job Description
Surgery Scheduler and Prior Authorization Specialist
Location: Southfield MI
Employment Type: Full-time Non-exempt
Position Summary
Epic Health is seeking a dedicated and detail-oriented Surgery Scheduler and Prior Authorization Specialist to join our Perioperative team. This role coordinates scheduling of surgical procedures and obtains necessary authorizations from insurance companies to ensure a smooth timely surgical experience for patients and providers.
The role requires strong knowledge of medical terminology CPT/ICD coding basics insurance verification processes and proficiency with EHR and practice management systems.
Key Responsibilities
- Schedule surgeries pre-op appointments and post-op follow-ups according to physician orders surgeon availability and facility protocols.
- Coordinate with patients surgeons anesthesiologists nursing staff and facility teams to confirm dates times and pre-operative instructions.
- Obtain prior authorizations for surgical procedures durable medical equipment and related services through timely submission to payers.
- Verify patient insurance coverage and eligibility; determine benefit details copays deductibles and out-of-pocket responsibilities.
- Prepare and submit complete authorization packets including clinical documentation operative indication and supporting diagnoses/CPTs.
- Track authorization status; follow up on pending/denied requests; appeal denials as needed in coordination with Revenue Cycle.
- Maintain accurate and up-to-date authorization records in the EHR and scheduling systems; update patient charts with authorization numbers and notes.
- Ensure required consents pre-op clearances and necessary diagnostic testing are completed prior to the surgery date.
- Communicate clearly and compassionately with patients regarding scheduling timelines authorization status financial responsibility and pre-op instructions.
- Collaborate with the prior authorization team billing and clinical staff to streamline workflows and reduce denial rates.
- Monitor and report scheduling and authorization KPIs (authorization turnaround denial rate on-time case starts) to manager.
- Participate in continuous improvement initiatives to improve scheduling efficiency authorization accuracy and patient experience.
Skills & Qualifications
Minimum Qualifications:
- High school diploma or GED required; Associates degree or healthcare certificate preferred.
- Minimum 2 years experience in medical scheduling prior authorizations or related healthcare administrative role.
- Working knowledge of medical terminology CPT and ICD-10 coding fundamentals applicable to surgical procedures.
- Demonstrated experience with insurance verification prior authorization submissions and payer communications.
- Proficiency with Electronic Health Record (EHR) systems and scheduling software; experience with Athena or similar systems preferred.
- Excellent verbal and written communication skills; strong customer service and patient-facing experience.
- Strong organizational skills with the ability to multitask prioritize and meet deadlines in a fast-paced environment.
- High attention to detail and accuracy when entering authorization details and schedule information.
Preferred Qualifications:
- Previous experience as a Medical Assistant Surgical Scheduler or in a hospital/ASC scheduling office preferred.
- Familiarity with payer portals electronic prior authorization platforms and standard appeal processes.
- Certification in medical billing/coding (CPC CCA) or prior authorization specialist certification is a plus.
- Bilingual (Spanish/English) highly desirable for patient communication in our service area.
Core Competencies
- Patient-centered communication and empathy.
- Problem-solving and critical thinking when resolving authorization issues or scheduling conflicts.
- Time management and the ability to prioritize urgent surgical cases.
- Team collaboration across clinical and administrative stakeholders.
- Data accuracy confidentiality and compliance with HIPAA regulations.
Work Conditions & Physical Requirements
- Typical office environment in a clinical setting.
- Must be able to sit for extended periods while working at a computer/phone.
- Occasionally lift up to 20 lbs.
- Travel between site locations as needed.
- May be required to work occasional extended hours during high-volume scheduling periods.
Compensation & Benefits
- Competitive hourly wage based on experience.
- Comprehensive benefits package including medical dental vision and life insurance.
- 401(k).
- Paid time off (PTO) and paid holidays.
- Employee wellness programs and professional development support.
Why Join Epic Health
At Epic Health were not just filling roles were building a best-in-class patient care experience. By joining our Perioperative team youll:
- Play a direct role in ensuring patients have seamless stress-free surgical care.
- Gain exposure to multi-specialty surgical scheduling in a high-growth healthcare organization.
- Work alongside compassionate professionals who value collaboration innovation and patient-first service.
- Be part of a company expanding nationally with opportunities for career growth and advancement.
Required Experience:
IC
Employment Type
Full-Time
