SURGICAL AUTHORIZATION ASSISTANT

Description

São Lucas Hospital of PUCRS is part of a global institution: the Marist Network! We are present in more than 80 countries worldwide and have over 10,000 employees. In Rio Grande do Sul, the Marist Network comprises the Pontifical Catholic University of Rio Grande do Sul \- PUCRS, InsCer \- Brain Institute, Sports Park, private schools, and social units. Are you interested? If you identify with our purpose and seek your professional growth and development, let’s do it together! **Responsibilities and Duties** **Main Responsibilities:** * Receive and analyze requests for surgical procedure authorizations, 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 required documentation to obtain authorizations from health insurance providers. * Collaborate with the surgical scheduling department to ensure authorizations are obtained within the timeframe necessary 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 impasses related to authorizations. * Monitor the status of authorization requests and conduct follow\-ups with insurance providers, ensuring 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 status. * Notify surgeons and medical secretariats regarding authorization status, 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 status. * Notify surgeons and medical secretariats regarding authorization status, 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 **Additional Information:** * Experience in authorization processes, preferably for surgical procedures. * Knowledge of health insurance providers’ authorization processes and regulations, as well as basic knowledge of medical terminology and procedures. **Additional Information** **Join our team!** We are a Marist 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 assistance; * Discount on short-term courses at PUCRS; * Access to the Ir. José Otão Library at PUCRS; * Discount on activities at PUCRS Sports Park; * Discount at Colégio Marista Champagnat; * Discount on Nursing Technician and Surgical Instrumentation Technician courses at Escola Valentia. With the mission of promoting life through healthcare assistance, education, and research, São Lucas Hospital of PUCRS is the world’s first Marist hospital and has been providing comprehensive, humanized care for nearly 50 years. Together with our people, we aim to be recognized as an institution of excellence in care — welcoming and continuously striving for the best for everyone who finds their well\-being here. HSL is a philanthropic hospital with over five thousand employees across clinical, administrative, and support areas. Operating in more than 40 specialties, São Lucas Hospital is Qmentum Diamond accredited and ranked among the top 100 hospitals in Brazil according to the World’s Best Hospitals ranking (Newsweek/Statista) in 2021, 2022, 2023, and 2024; additionally, it has twice received the Top Ser Humano award 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 do it together!