JOB REQUIREMENTS: Position Description: As the Surgical Prior Authorization Coordinator III in Orthopaedic Surgery you will be responsible for managing the process of securing prior authorizations for surgical procedures and services. This role involves assigning or verifying CPT codes based on provider documentation, verifying insurance coverage, coordinating with healthcare providers, and communicating with insurance companies to ensure that patients receive the necessary approvals for their surgical treatments. Primary Functions Assign and/or verify CPT, ICD-10 CM coding, and modifiers based upon provider documentation. Keep coding and documentation resources for the providers and surgery schedulers updated on a continuous basis. For clinical procedures and special handle procedures: Initiate and manage the process of obtaining prior authorizations from insurance companies. Ensure that medical necessity requirements are met and work with healthcare providers to gather necessary documentation. Collaborate with healthcare providers, insurance companies, and patients to facilitate the authorization process and address any issues or discrepancies. Manage departmental drug inventory and distribution. If a surgical authorization is denied, work with clinical team as needed. Stay updated on relevant regulations and insurance policies to ensure compliance with all guidelines. Identify and report trends in surgical authorization denials and work with the Sr. Reimbursement Manager to implement quality improvement measures. Collaborate with surgical schedulers and healthcare providers to ensure that scheduled surgeries align with approved authorizations. Provide patients with information about the prior authorization process and their financial responsibilities, answering any questions or concerns. Provides assistance, training, and/or coverage to other team members as needed, acts as valuable resource for all surgeons and APPs in the Department. Knowledge - Skills - Abilities Previous experience in healthcare administration, medical billing, or revenue cycle management. Knowledge of surgical procedures, medical terminology, and the surgical authorization process. Strong communication and interpersonal skills. Attention to detail and the ability to work in a fast-paced, deadline-driven environment. Knowledge of insurance verification processes and healthcare compliance regulations. Familiarity with electronic health record (EHR) systems. Coding experience related to surgical procedures or coding certification (CPC, CPC-A, CCS-P, CCA, RHIT, or RHIA) #LI-SN1 Preferred Schedule: Position... For full info follow application link. EEO/AA Minorities/Females/Vets/Disability The Medical College of Wisconsin is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, veteran status, disability or sexual orientation. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/8BE40DA4C0124DCD Qualified females, minorities, and special disabled veterans and other veterans are encouraged to apply.