AUTHORIZATION ASSISTANT

Description

Job Summary: The professional will be responsible for receiving, analyzing, and ensuring authorization for surgical procedures, interacting with health plan operators, physicians, and patients. Key Highlights: 1. Analyze and ensure authorizations for surgical procedures 2. Negotiate with health insurance providers and health plan operators 3. Communicate authorization status to physicians and patients Hospital São Lucas da PUCRS is part of a global institution: the Marista Network! We are present in more than 80 countries worldwide and have over 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 your professional growth and development, let’s move forward together! **Responsibilities and Duties** **Main Responsibilities:** * Receive and analyze authorization requests for surgical procedures, verifying compliance with requirements established by health plan operators. * Ensure all surgical procedures are duly authorized within deadlines stipulated by health plan operators. * Prepare and submit required documentation to obtain authorizations from health plan operators. * 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 authorization denials or delays. * Negotiate with health insurance providers and health plan operators to resolve procedure denials, coverage adjustments, and other authorization-related impasses. * Monitor authorization request status and perform follow\-ups with health plan operators, ensuring adherence to established deadlines. * Establish direct communication with health plan operators, 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 plan operators, 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 education **Additional Information:** * Experience in authorization processes, preferably for surgical procedures. * Knowledge of health plan operators’ authorization processes and regulations, and 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 postgraduate (Lato Sensu) 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 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 Marist hospital and has been delivering 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 professionals across clinical, administrative, and support areas. Operating in more than 40 specialties, Hospital São Lucas is Qmentum Diamond accredited and ranked among the top 100 hospitals in Brazil according to the World’s Best Hospitals ranking by Newsweek/Statista in 2021, 2022, 2023, and 2024; additionally, it has twice received the Top Ser Humano award from ABRH\-RS and is 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!