Medical Authorization Specialist (Spine Surgery)

Before you apply

Job source

Himalayas

Applying on

himalayas.app

Workplace

Fully remote

US state

Nationwide remote

Category

Administrative

Link last checked

Not checked yet

Posted

5 days ago

Closes

11/12/2026

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About the role

Job Title: Medical Authorization Specialist (Spine Surgery) Position type: Full-Time Work hours: 8:00 AM to 5:00 PM Pacific Time Work days: Monday to Friday Salary: $5 - $7 per hour, depending on experience Our client is a U.S.-based medical practice specializing in spine care and surgical treatment. 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. You will work behind the scenes to help ensure procedures are properly authorized, documentation is complete, insurance requirements are addressed, and denied authorizations are followed through the appeals process. The ideal candidate understands the urgency and accuracy required when coordinating surgical authorizations and is comfortable communicating directly with insurance companies, navigating multiple payer portals, reviewing clinical documentation, and working with procedure and insurance codes. Scope of Work / Responsibilities Surgery Authorizations & Insurance Verification 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 Insurance Appeals & Denial Management Review denied or rejected surgery authorization requests Identify denial reasons and determine the appropriate next steps Assist with preparing and submitting insurance appeals Gather clinical documentation, notes, reports, and other supporting records required for appeals Track appeals and follow up within appropriate timelines Maintain clear documentation of appeal status and insurance correspondence Communicate updates and outstanding requirements to the appropriate internal team members Insurance Portal Navigation & Communication Navigate multiple insurance portals to submit, review, and track authorization requests Obtain or coordinate appropriate portal access when necessary Research payer-specific authorization requirements Make outbound calls to insurance companies regarding authorizations, appeals, claim status, and documentation requirements Communicate professionally with insurance representatives Document calls, reference numbers, decisions, and follow-up requirements accurately Medical Coding & Documentation Support Review relevant procedure and insurance codes associated with authorization requests Work with spine surgery and orthopedic procedure codes when applicable Reference clinical notes, reports, and supporting documentation through EHR/EMR systems Use systems such as Epic, Cerner, or Athena to locate information needed for authorization and appeal processes Prepare and organize reports, spreadsheets, and authorization-related documentation Maintain accurate tracking spreadsheets and administrative records Ensure all information is handled accurately and in accordance with HIPAA and confidentiality requirements Top 3 Priorities 1. Surgery Authorization Management Accurately manage and process surgery authorizations, with particular emphasis on orthopedic and spine procedures. 2. Insurance Portal Navigation Confidently navigate different payer portals, obtain appropriate access, submit authorization requests, and track cases through completion

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