AUTHORIZATION ASSISTANT

Description

Job Summary: A professional responsible for managing and ensuring the authorization of surgical procedures with health insurance providers, performing analysis, submission of documentation, and communication with all involved parties. Key Highlights: 1. Experience in authorizing surgical procedures, preferably 2. Knowledge of authorization processes and regulations of health insurance providers 3. Professional committed to excellence in patient care Hospital São Lucas da PUCRS is part of a global institution: the Marist Network! We operate in over 80 countries worldwide and have more than 10,000 employees. In Rio Grande do Sul, the Marist Network comprises the Pontifical Catholic University of Rio Grande do Sul \- PUCRS, InsCer \- Institute of the Brain, the Sports Park, private schools, and social units. Interested? If you identify with our mission and seek professional growth and development, let’s work together! **Responsibilities and Duties** **Main Responsibilities:** * Receive and analyze requests for authorization of surgical procedures, verifying compliance with requirements established by health insurance providers. * Ensure all surgical procedures are duly authorized within deadlines set by health insurance providers. * Prepare and submit required documentation to obtain authorizations from health insurance providers. * Collaborate with the surgical scheduling department to ensure authorizations are obtained within the necessary timeframe for procedure execution. * Identify and correct potential errors in requests or submitted documentation to minimize denials or delays in authorizations. * Negotiate with health plans and insurance providers to resolve procedure denials, coverage adjustments, and other authorization-related impasses. * Monitor the status of authorization requests and conduct 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 secretariats regarding 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 secretariats regarding authorization statuses, including approvals, pending items, or denials. **Requirements and Qualifications** **Requirements and Qualifications:** **What We Are Seeking:** * Professional aligned with our mission of excellence in patient care. **What You Must Have:** * Completed High School Education **Additional Information:** * Experience in authorizations, preferably for surgical procedures. * Knowledge of authorization processes and regulations of health insurance providers, and basic knowledge of medical terminology and procedures. **Additional Information** **Join Our Team!** We are a Marist institution that believes 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 postgraduate (Lato Sensu) programs. **Some Benefits:** * Free parking; * Subsidized cafeteria; * Access to medical and dental health plans; * Childcare allowance; * Discounts on short-term courses at PUCRS; * Access to the Ir. José Otão Library at PUCRS; * Discounts on activities at the PUCRS Sports Park; * Discount at Colégio Marista Champagnat; * Discounts on Nursing Technician and Surgical Instrumentation Technician courses at Escola Valentia. With a mission to promote life through healthcare, teaching, and research, Hospital São Lucas da PUCRS is the world’s first Marist hospital and has provided comprehensive, humanized care for nearly 50 years. Together with our people, we aim to be recognized as an institution of exceptional, compassionate care that always seeks the best for everyone who finds 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 ranks among the top 100 hospitals in Brazil according to the World’s Best Hospitals ranking (Newsweek/Statista) in 2021, 2022, 2023, and 2024; it has also been awarded Top Ser Humano twice by 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 wish for professional development? Let’s work together!