[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-262147-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-262147-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","pisa-surgical-prior-authorization-specialist-2025","PISA Surgical Prior Authorization Specialist - 2025","","Surgical Prior Authorization Specialist role focused on obtaining insurance pre-authorizations for surgical services. Accurately inputs data into EMR, reviews surgical schedules to identify payors needing authorization, and matches clinical information to medical terms, diagnoses, and procedure codes using CPT, ICD-10, NCCI edits, and LCD policies. Coordinates with scheduling, patients, providers, and coordinators for readiness and denial updates, assists patients with insurance submissions when needed, and performs light administrative duties while handling follow-ups, tracking communication attempts, verifying active coverage, and maintaining HIPAA-compliant confidentiality.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/pisa-surgical-prior-authorization-specialist-2025/262147/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/pisa-surgical-prior-authorization-specialist-2025/262147.png","ImageObject",442,249,{"name":42,"@type":43},"Maya Linwood","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-02","2026-09-14",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What are the core responsibilities of the Surgical Prior Authorization Specialist?","Question",{"text":63,"@type":64},"Obtain insurance pre-authorizations for surgical services, enter information into the EMR accurately and timely, and review surgical schedules to determine which payors require authorization.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which skills and knowledge are required to support authorization requests?",{"text":68,"@type":64},"The role requires medical terminology knowledge and the ability to apply CPT codes, ICD-10, NCCI edits, and LCD policies, along with understanding the authorization workflow.",{"name":70,"@type":61,"acceptedAnswer":71},"How does the position handle insurance denials and patient communication?",{"text":72,"@type":64},"It communicates with patients, providers, and coordinators when authorization requests are denied, works directly with patients to assist with obtaining authorization when needed, and follows up on all denials while tracking communication attempts.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},262147,1791662900,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,113,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":111,"slug":112},17,40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":110,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":11,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":139,"read_time":4},962084928432,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","| Job Title: |  | Prior Authorization Specialist | Job Category: |  | Job Category |\n| --- | --- | --- | --- | --- | --- |\n| Department/Group: |  | Scheduling and Prior Auth | Job Code/ Req\\# : |  | Job Code/ Req\\# |\n| Location: |  | 1020 S. Harrison Rd | Travel Required: |  | None |\n| Level/Salary Range: |  | $31,200 – $40k | Position Type: |  | Full Time |\n| HR Contact: |  | Jennifer Irwin |  |  |  |\n| Job Description |  |  |  |  |  |\n| ROLE AND RESPONSIBILITIES\u003Cbr>The Surgical Prior Authorization Specialist is responsible for obtaining pre-authorizations from insurance carriers. Inputs the data accurately and timely into the EMR software. Review surgical schedules to determine which payors require prior authorization. Review clinical data matching it against specified medical terms and diagnoses or procedure codes and follow established procedure for authorization requests. Knowledgeable in medical terminology, CPT codes, ICD-10, NCCI edits and LCD policies.\u003Cbr>Communicate with the surgical scheduling coordinator that prior authorization has been obtained and that the patient is ready to be scheduled.\u003Cbr>Communicate with patients , providers and coordinators to let them know if their insurance has denied the authorization request.\u003Cbr>Work directly with patients to have them assist with obtaining prior authorization from their insurance carrier when needed. The position will also perform light administrative duties, and any other tasks as assigned.\u003Cbr>QUALIFICATIONS AND EDUCATION REQUIREMENTS\u003Cbr>Minimum one-­‐year experience with prior authorization experience in healthcare.\u003Cbr>PREFERRED SKILLS\u003Cbr>• Computer skills include web browsing, Excel, EMR software and use of insurance portals\u003Cbr>• Excellent verbal and written communication skills\u003Cbr>• Understanding of authorization procedure workflow\u003Cbr>• Knowledge of medical terminology , CPT codes and ICD-10\u003Cbr>• Ability to analyze data given to provide the appropriate information to insurance companies\u003Cbr>• Ability to respond to questions in a tactful and professional manner\u003Cbr>• Ability to multitask, prioritize tasks and work efficiently\u003Cbr>• Understanding of HIPPA regulations, respect for patient confidentiality\u003Cbr>• Efficiency and attention to detail , document and track all communication attempts with insurance providers\u003Cbr>• Follow-up on all denials\u003Cbr>• Ensure accuracy of patient data, demographic and insurance information\u003Cbr>• Verify insurance is active |  |  |  |  |  |\n| Reviewed By: | Denise Riesgo |  | Date: | 05/30/2025 |  |\n| Approved By: | Jennifer Irwin |  | Date: | 10/30/17 |  |\n| Last Updated By: |  |  | Date/Time: |  |  |","cbCaicDVNUB1caB3","https://ap.wps.com/l/cbCaicDVNUB1caB3","pdf",79635,"English","[{\"question\":\"What are the core responsibilities of the Surgical Prior Authorization Specialist?\",\"answer\":\"Obtain insurance pre-authorizations for surgical services, enter information into the EMR accurately and timely, and review surgical schedules to determine which payors require authorization.\"},{\"question\":\"Which skills and knowledge are required to support authorization requests?\",\"answer\":\"The role requires medical terminology knowledge and the ability to apply CPT codes, ICD-10, NCCI edits, and LCD policies, along with understanding the authorization workflow.\"},{\"question\":\"How does the position handle insurance denials and patient communication?\",\"answer\":\"It communicates with patients, providers, and coordinators when authorization requests are denied, works directly with patients to assist with obtaining authorization when needed, and follows up on all denials while tracking communication attempts.\"}]","PISA Surgical Prior Authorization Specialist - 2025 | PDF",1789359776]