SURGICAL AUTHORIZATION ASSISTANT

Description

Job Summary: The professional will be responsible for receiving, analyzing, and submitting surgical procedure authorization requests, ensuring compliance and effective communication with health insurance providers and medical teams. Key Highlights: 1. Analyze and submit surgical authorization requests 2. Ensure compliance with health insurance provider requirements 3. Negotiate with health plans to resolve impasses Hospital São Lucas da PUCRS is part of a global institution: the Marista Network! We operate in over 80 countries worldwide and have more than 10,000 employees. In Rio Grande do Sul, the Marista Network comprises the Pontifical Catholic University of Rio Grande do Sul \- PUCRS, InsCer \- Brain Institute, Sports Park, private schools, and social units. Interested? If you identify with our purpose and seek professional growth and development, let’s move forward together! **Responsibilities and Duties** **Main Responsibilities:** * Receive and analyze surgical procedure authorization requests, verifying compliance with requirements established by health insurance providers. * Ensure all surgical procedures are duly authorized within deadlines stipulated by health insurance providers. * Prepare and submit necessary documentation to obtain authorizations from health insurance providers. * Collaborate with the surgical scheduling department to ensure authorizations are obtained within the required timeframe for procedure execution. * Identify and correct potential errors in requests or submitted documentation to minimize authorization rejections or delays. * Negotiate with health plans and insurance providers to resolve procedure rejections, coverage adjustments, and other authorization-related impasses. * Monitor the status of authorization requests and perform follow\-ups with insurance providers to ensure adherence to established deadlines. * Establish direct communication with health insurance providers, physicians, patients, and departments involved in the surgical process to clarify doubts and update authorization statuses. * Notify surgeons and medical secretaries of authorization statuses, including approvals, pending items, or denials. * Establish direct communication with health insurance providers, physicians, patients, and departments involved in the surgical process to clarify doubts and update authorization statuses. * Notify surgeons and medical secretaries of authorization statuses, including approvals, pending items, or denials. **Requirements and Qualifications** **Requirements and Qualifications:** **What we are looking for:** * A professional aligned with our purpose of excellence in patient care. **What you need to have:** * Completed High School education **Additional Information:** * Experience in authorizations, preferably for surgical procedures. * Knowledge of health insurance provider authorization processes and regulations, as well as basic knowledge of medical terminology and procedures. **Additional Information** **Join our team!** We are a Marista institution and believe in the potential of our employees. We encourage professional training and development through scholarship grants: * 40% discount on undergraduate programs at PUCRS; * 50% discount on PUCRS Lato Sensu postgraduate programs. **Some Benefits:** * Free parking; * Subsidized cafeteria; * Access to medical and dental health plans; * Childcare allowance; * Discount on short-term courses at PUCRS; * Access to the Ir. José Otão Library at PUCRS; * Discount on activities at the PUCRS Sports Park; * Discount at Colégio Marista Champagnat; * Discount on Nursing Technician and Surgical Instrumentation Technician courses at Escola Valentia. With a mission to promote life through healthcare assistance, teaching, and research, Hospital São Lucas da PUCRS is the world’s first Marista hospital and has provided comprehensive, humanized care for nearly 50 years. Together with our people, we aim to be recognized as an excellent, welcoming institution that always seeks the best for everyone who finds their well\-being here. HSL is a philanthropic hospital employing over five thousand staff across clinical, administrative, and support areas. Operating in more than 40 specialties, Hospital São Lucas holds Qmentum Diamond accreditation and is ranked among the 100 Best Hospitals in Brazil according to the World’s Best Hospitals ranking (Newsweek/Statista) in 2021, 2022, 2023, and 2024; it has also received the Top Ser Humano award twice from ABRH\-RS and was the first hospital in Latin America to receive Qmentum Diamond accreditation for its cardiology service. Do you identify with our purpose and seek professional development? Let’s move forward together!