Prior Authorization Specialist

UBMD Surgery has grown to be one of the largest and most respected non-profit surgical practices in Western New York. As a part of the UBMD Physicians’ Group, we take pride in teaching the next generation of surgeons how to be the doctors of the future, all while providing excellent patient care and outcomes.

Our certified and fellowship-trained surgeons see and treat patients at various locations including Buffalo General Medical Center, Erie County Medical Center, John R. Oishei Children’s Hospital, Millard Fillmore Suburban Hospital, Niagara Falls Memorial Medical Center, and Buffalo VA Medical Center.

We offer a comprehensive benefit package that includes Health Insurance, Dental, Vision, Company Paid Life Insurance, Company Contributed Pension, PTO, and 14 paid Holidays.

UBMD Surgery also hosts company sponsored events and scholarship opportunities available to all employees.

Department: Surgery 

Reports to: Office Supervisor

Position Summary:  This position is responsible for obtaining prior authorizations for testing, procedures, & surgeries.

Essential Functions:

• Obtain prior authorization for all imaging, procedures, and surgery across various specialties: i.e. General, Vascular, Bariatric Surgery.
• Track prior authorizations in conjunction with surgical scheduling to avoid expiring authorizations.
• Work retro-authorizations when necessary
• Work denials by resubmitting appropriate documentation and working with managers/physician to coordinate peer to peers to ensure proper coverage for upcoming surgeries.
• Manage incoming documents and assist with completion of forms
• Deliver exemplary customer service in order to provide a positive experience for all patients
• Perform other duties as assigned

Education: High School Diploma

Experience/Qualifications: 1+ years of insurance verification, familiar with medical terminology, professional phone courtesy. Hybrid work environment (2-3 days a week required in office).

*Pay commensurate with education and experience

UBMD Surgery is an equal employment opportunity (EEO) employer. We are committed to the principles of equality in employment and opportunity for all employees without regard to race, color, citizenship status, national origin, ancestry, gender or expression whether or not such gender identity or expression differs from the employee’s physical sex as assigned at birth (including transgender status), sexual orientation, age, weight, religion, creed, physical or mental disability, predisposing genetic characteristics and information, marital status, familial status, domestic violence victim status, veteran status, military status, political affiliation or any other factor and/or status protected by law. We expect all employees to adhere to these principles of equality which apply to all aspects of the employment relationship including hiring, job selection, job assignment, compensation, corrective action, termination, access to benefits and training and other privileges of employment.

UBMD Surgery is a smoke-free and drug-free workplace in compliance with local, state and/or federal guidelines.