Under the supervision of the Practice Manager, Incumbent serves as coordinator for all authorizations for the Department of Orthopedics. This position will obtain both surgical authorizations and clinic orderables / appointment authorizations. The position will have primary duties and responsibilities to: ensure smooth flow of authorizations; oversee data entry for the authorization unit; and identify and resolve systemic issues with authorizations as they arise and assisting surgery schedulers in obtaining auths as needed. This position works closely with our surgeons, NPs, PAs and internal departments to ensure that all required information has been received and that it is in EPIC. This position is responsible for facilitating the processing of authorizations associated with orders placed in EPIC.

FUNCTION NAME / TASKS Authorizations Oversight and Coordination A. Ensure adherence to authorization process and ensure that all authorization requests are submitted within three working days. B. Independently resolve issues with insurance companies as they relate to authorizations. C. Identify and provide solutions for systemic problems with authorizations. D. Frequently resolve a wide variety of operational problems requiring sound judgment. E. Serve as a resource for training and/or troubleshooting purposes for all surgeons and clinical providers within the Department of Orthopedics F. Manage authorization request queue and ensure all requested authorizations are obtained and documented appropriately Background in orthopedic surgery is instrumental in determining referral and authorization needs of this patient population. It is complex and expands in many areas: office visits/specific diagnosis/ DME/ radiology/ PT/Home health/ Surgery etc.

• Three (3) years of directly related experience in a large complex healthcare or oncology clinic setting; or an equivalent combination of education and experience.

• In depth knowledge of hospital registration and insurance authorizations, including ICD-9, CPT, and HCPCS Codes.

• Prior experience with EPIC, IDX , PCIS, and MS Office (Word, Excel, Outlook, PowerPoint), with demonstrated skill working between multiple systems during calls.

• Possess excellent customer service skills.

• Familiar with EPIC Cadence and WQs preferred.

• Experience working in a surgical authorization coordination unit or academic medical center.

• Ability to work variable hours/shifts to meet the needs of the department.
• Must be able to float between various department locations (including the Encinitas SD Cancer Center).