We are looking for a highly organized, experienced, and proactive Surgery Coordinator & Authorization Specialist to join our busy, multi-physician orthopedic practice group in Arizona. In this full-time role, you will serve as the central point of contact for surgical patients, managing the entire surgery coordination process while securing timely insurance authorizations. You will work closely with our orthopedic surgeons, clinical team, and administrative staff to ensure smooth scheduling, authorization approval, and positive patient experiences in a high-volume environment.
Key Responsibilities
- Coordinate all aspects of orthopedic surgery scheduling, including procedures at hospitals, ambulatory surgery centers, and in-office suites.
- Obtain prior authorizations for surgeries, injections, imaging, DME, and related services from all payer types (commercial, Medicare, AHCCCS/Medicaid, workers’ compensation).
- Review clinical documentation, operative reports, and medical necessity to build complete authorization submissions.
- Submit authorizations through portals, fax, phone, and electronic systems; aggressively follow up on pending requests and appeals.
- Communicate surgery details, insurance authorization status, financial responsibilities, and pre-operative instructions clearly to patients.
- Verify insurance benefits, obtain referrals when needed, and estimate patient financial obligations.
- Maintain surgery schedules, block times with facilities, and coordinate pre-op testing and clearances.
- Track and document all activities in the EHR; ensure accurate surgical logs and reports for the practice.
- Collaborate with surgeons, medical assistants, billing, and ASC and hospital staff to resolve issues and prevent delays.
- Manage high-volume caseload efficiently while maintaining accuracy and excellent customer service.
- Stay up to date on orthopedic procedure coding (CPT/ICD-10), payer policies, and Arizona-specific insurance requirements.
- Assist with additional practice initiatives as needed to support surgical operations.
Qualifications & Requirements
- Minimum 2+ years of experience in surgery coordination and/or insurance prior authorizations, preferably in orthopedics or a surgical specialty.
- Strong working knowledge of common orthopedic procedures (joint replacements, arthroscopies, sports medicine, fracture care, etc.).
- Thorough understanding of Arizona insurance payers including BCBS, Aetna, UnitedHealthcare, Cigna, AHCCCS, and workers’ compensation.
- Excellent organizational and time-management skills with the ability to prioritize in a fast-paced, high-volume setting.
- Outstanding verbal and written communication skills; customer-service oriented with a calm, professional demeanor.
- Proficient in EHR systems (ModMed or similar ), insurance portals, and Microsoft Office Suite.
- High school diploma or equivalent required; medical billing/coding certification (CPC, CMAA, or equivalent) strongly preferred.
- Must be reliable, detail-oriented, and able to work independently as well as part of a team.
Preferred Qualifications
- Previous experience in a multi-provider orthopedic group or busy surgical practice.
- Familiarity with surgical scheduling software and facility block time management.
- Experience handling authorization appeals and denials.
- Bilingual (English/Spanish) is a significant plus.
Pay: $22.00 - $26.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Flexible schedule
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
