Surgical & Clinical Care Coordinator - CPT & Authorization Specialist

About the Role

We are seeking a highly skilled Surgical & Clinical Care Coordinator with a clinical background in Nursing, Physical Therapy, or Podiatry . This role combines clinical knowledge with technical revenue cycle expertise—specifically reading physician orders, identifying correct CPT codes, securing prior authorizations, and coordinating end-to-end patient scheduling.

You will serve as the primary engine translating doctor orders into authorized, scheduled procedures and care plans. You must be deeply comfortable navigating CPT/ICD-10 codes, fielding phone calls regarding authorization details, and guiding patients through their appointment and surgical schedules.

Requirements

Key Responsibilities

• Doctor Order Processing & CPT Verification
• Review physician orders for surgical procedures, diagnostic tests, therapy sessions, or clinical services.
• Validate and match orders against correct CPT/HCPCS codes and ICD-10 diagnoses to ensure complete coding accuracy before submission.
• Prior Authorization Management & Phone Support
• Initiate, track, and secure insurance prior authorizations based on specific CPT codes and clinical necessity guidelines.
• Answer inbound and place outbound phone calls to insurance companies, medical providers, and patients to resolve authorization inquiries, verify coverage rules, and address peer-to-peer or appeal requirements.
• Surgical & Appointment Coordination
• Contact patients directly to schedule surgical procedures, pre-operative testing, and clinical follow-ups once authorizations are approved.
• Coordinate surgery times, facility block times, and physician calendars.
• Walk patients through pre-procedure instructions, required medical clearances, and appointment logistics over the phone.
• Documentation & EHR Workflow
• Maintain meticulous records of authorization numbers, expiration dates, approved CPT codes, and scheduling updates within the practice EHR/EMR system.
• Monitor pending orders to ensure zero delays between physician order placement and final patient scheduling.

Qualifications & Requirements

• Clinical Background (Required): Formal education or background in Nursing (RN/LPN/BSN) , Physical Therapy (PT/PTA) , or Podiatry .
• CPT & Coding Knowledge: Demonstrated ability to accurately read doctor orders, identify CPT codes, and align them with payer authorization rules.
• Surgical & Care Coordination: Proven experience managing surgical scheduling, pre-testing requirements, and care navigation.
• Prior Authorizations: Strong hands-on background securing prior auths across various insurance payers.
• Phone Communication: Excellent, articulate English speaking skills for calling insurance reps, coordinating with doctors' offices, and speaking empathetically with patients.