OMFS Prior Authorization Specialist

Oral Surgery Utilization Specialist

The Oral Surgery Utilization Specialist is responsible for correctly and efficiently facilitating the prior authorization and scheduling process for Oral Maxillofacial Surgery patients, by ensuring that authorization is obtained. Communicate financial responsibility to the clinic scheduler and front desk personnel if needed. Works to ensure that Medicaid information is accurate and, in cases of other commercial insurance, ensures that member information is accurate. Facilitate the flow of information between the provider, insurance company, and the patient. Document all pertinent information in the appointment area of the order. Perform clerical work using various applications.

Minimum Requirements

• High school diploma or equivalent.
• Experience in healthcare insurance verification and billing protocols.
• Two years' experience in face to face and/or customer service or equivalent field.
• Working knowledge of medical terminology, CPT codes, and ICD10 codes.
• Working knowledge of Microsoft Office products.
• Ability to type 30 wpm.
• Communication and customer service skills required to gather and exchange information with patients, families, hospital staff members, physicians, and third party payers.
• Ability to work and think independently, ability to handle sensitive information with discretion, attention to detail, ability to handle multi-tasking and change in priorities.

Preferred Qualifications

• Experience in authorization of outpatient procedures.
• Course work in medical terminology and coding.

Working at University Health is about making a difference. It's providing the best care to every patient every day. University Health (UH), is committed to being a leader in providing a culturally inclusive workplace for our employees. UH is an equal opportunity employer. We value and celebrate our differences. We are committed to equal employment opportunity regardless, but not limited to race, ethnicity, religion, beliefs, sex (including pregnancy, gender identity and expression, sexual orientation), national origin, ancestry, language, age, citizenship, socioeconomic status, literacy, disability, mobility, abilities, veteran status, and any other category protected by applicable law.