Location: Austin,Texas
Facility: Medical Park Tower
Department/Specialty: Hip and Knee Replacement
Schedule: Day Shift | Monday - Friday 8:00a - 5:00p
How you'll make an impact in this role:Execute Strategic Surgical Authorizations by serving as the primary lead for securing medical necessity approvals for complex hip and knee procedures, ensuring all surgical cases are financially cleared prior to the date of service.
Orchestrate High-Cost Clinical Approvals by managing the end-to-end authorization process for specialized Viscosupplementation (HA injections) and advanced diagnostic imaging, including CT scans and MRIs.
Direct Revenue Cycle Recovery by aggressively managing AthenaHealth "Work Buckets," identifying the root cause of claim denials and resolving billing discrepancies to maximize reimbursement.
Master Insurance Eligibility & Verification by conducting deep-dive reviews of patient benefits to provide accurate financial forecasting for high-value orthopedic surgeries.
Synchronize Surgical Scheduling & Logistics by coordinating with providers and facilities to align authorized procedure windows with surgical staff availability.
Champion Data Integrity by maintaining meticulous records within the EMR, ensuring all authorization numbers and clinical documentation are accurately tethered to patient accounts.
Education:
Proven Reimbursement Mastery: Significant experience in medical billing, collections, or reimbursement coordination, specifically within a specialty surgical clinic.
Surgical Scheduling Expertise: Demonstrated success in navigating the logistical complexities of scheduling and authorizing multi-stage orthopedic procedures.
Insurance Landscape Command: Expert-level knowledge of insurance eligibility, benefit verification, and the specific nuances of orthopedic prior-authorization requirements.
Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 99,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter.
Equal employment opportunity employer:Equal employment opportunity employer
Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.
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E-Verify statement
Employer does not participate in E-Verify and therefore cannot employ STEM OPT candidates.
Benefits:Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community
Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.