[Hiring] Medical Authorization Specialist @Winning Assistants

Role Description

We are seeking an experienced and detail-oriented Medical Authorization Specialist (Spine Surgery) to support the practice with surgery authorizations, insurance appeals, insurance portal navigation, and related administrative processes. This is a specialized, non-patient-facing role designed for someone who already has hands-on experience processing surgery authorizations and can confidently manage cases with minimal supervision.

• Manage and process surgery authorizations, particularly for orthopedic and spine procedures.
• Review authorization requirements and verify necessary insurance information.
• Submit prior authorization requests through appropriate insurance portals.
• Track authorization requests from initial submission through determination.
• Ensure required documentation and supporting information are complete and accurate.
• Follow up on pending authorizations and outstanding requirements.
• Maintain accurate records of authorization status, reference numbers, correspondence, and next steps.
• Assist with claims-related and insurance verification tasks as required.

Qualifications

• Previous hands-on surgery authorization experience is required.
• Previous experience navigating multiple insurance portals is required.
• Strong understanding of the prior authorization and insurance appeals process is required.
• Experience communicating directly with insurance companies is required.
• Experience submitting and tracking authorization requests from start to completion.
• Experience handling authorization denials and supporting the appeals process.
• Ability to determine documentation and information required by different insurance companies.
• Familiarity with insurance and medical procedure codes.
• Ability to review clinical notes, reports, and supporting medical documentation.
• Familiarity with EHR/EMR systems such as Epic, Cerner, Athena, or similar platforms.
• Strong attention to detail and accuracy.
• Ability to organize and track multiple authorization cases simultaneously.
• Ability to prioritize tasks based on urgency and authorization timelines.
• Strong documentation and follow-up skills.
• Professional communication skills when speaking with insurance representatives.
• Ability to work independently and consistently follow cases through resolution.
• Understanding of HIPAA, confidentiality, and the importance of accuracy when handling medical and insurance information.

Requirements

• Experience with orthopedic or spine surgery authorizations.
• Familiarity with spine surgery procedure and insurance codes.
• Understanding of workers’ compensation.
• Experience working with Epic, Cerner, or Athena.
• Experience using Google Workspace, particularly Google Sheets for authorization tracking.
• Experience using Microsoft Teams.
• Previous experience supporting a U.S.-based surgical, orthopedic, spine, or specialty medical practice.

Benefits

• Access to world-class support for questions, guidance, contract matters, and client communication.
• Premium VPN Access (Optional): A secure VPN license can be provided upon request.
• HIPAA & Cybersecurity Training + Certification (Provided).
• Top 1% VA Performance Training.
• Client-Approved U.S. Holidays.
• Client-Approved Paid or Unpaid Time Off.
• Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support.
• Optional Performance-Based Incentives.