Surgical Scheduler and Authorization Specialist in McLean, Virginia at PRIME ORTHO LLC

Prime Ortho | Tysons, VA | Full-Time | On-Site

Compensation: $24–$30 per hour, based on experience

Prime Ortho is a specialty orthopedic practice dedicated to providing exceptional patient care. Our physicians specialize in spine, sports medicine, and interventional pain management.

We are seeking an experienced, highly organized Surgical Scheduler & Authorization Specialist to support four physicians and manage the scheduling and authorization process for surgical procedures and interventional pain injections.

This is an excellent opportunity for a candidate who understands the complexities of orthopedic scheduling, is comfortable working directly with insurance companies, and can take ownership of cases from scheduling through authorization.

This is a fully in-office position at our Tysons, Virginia location, Monday through Friday.

• Independently manage surgical and procedure scheduling for four physicians specializing in spine, sports medicine, and interventional pain management.
• Coordinate surgical cases, outpatient procedures, and interventional pain injections with patients, physicians, surgical facilities, and clinical staff.
• Ensure procedure details, scheduling requirements, and supporting documentation are accurate and complete.
• Communicate preoperative instructions, scheduling updates, and outstanding requirements to patients.
• Proactively identify scheduling conflicts, missing documentation, and potential delays.
• Maintain organized, accurate records and ensure cases are appropriately tracked from scheduling through completion.

• Independently manage prior authorization requests for surgical procedures, spine interventions, sports medicine procedures, and interventional pain injections.
• Verify insurance eligibility, benefits, authorization requirements, and applicable payer guidelines.
• Submit authorization requests with appropriate clinical documentation and follow up consistently on pending cases.
• Work directly with commercial insurance plans, Medicare Advantage plans, and other payers to resolve authorization issues.
• Monitor authorization deadlines and communicate potential delays to physicians and clinical staff.
• Track authorization approvals, denials, appeals, and outstanding requests to help prevent avoidable cancellations.
• Identify denial reasons and coordinate next steps with the appropriate physician and clinical team.

• Coordinate peer-to-peer reviews between physicians and insurance company medical reviewers for denied authorizations.
• Schedule peer-to-peer appointments around physician availability and insurer deadlines.
• Gather denial letters, clinical documentation, and relevant authorization information before scheduled reviews.
• Communicate denial details and review outcomes to the appropriate team members.
• Track outcomes and ensure any additional documentation, appeals, or follow-up actions are completed promptly.

• Maintain accurate scheduling and authorization records within the practice's electronic systems.
• Use scheduling and practice management tools to monitor case status, identify outstanding tasks, and maintain an organized workflow.
• Collaborate with physicians, clinical staff, and administrative team members to improve efficiency.
• Protect patient confidentiality and comply with HIPAA requirements.

• Prior experience in surgical scheduling, preferably within an orthopedic, spine, sports medicine, pain management, or multispecialty practice.
• Strong hands-on experience obtaining prior authorizations for procedures.
• Experience managing insurance denials and coordinating peer-to-peer reviews.
• Ability to independently prioritize cases, manage deadlines, and follow up on outstanding authorizations.
• Excellent communication skills and the confidence to communicate professionally with insurance representatives, physicians, patients, and surgical facilities.
• Exceptional attention to detail, organization, and follow-through.
• Proficiency with electronic medical records and scheduling systems.
• Ability to work on-site five days per week at our Tysons office.

• Athenahealth experience strongly preferred.
• Surgimate experience strongly preferred.
• Direct experience in orthopedic spine and interventional pain management authorization workflows.
• Familiarity with procedure-specific payer requirements and common authorization denial issues.
• Experience coordinating high-volume surgical schedules for multiple physicians.
• Experience with appeals, authorization tracking, and payer follow-up.

• Health insurance
• Dental insurance
• Vision insurance
• Paid time off (PTO)
• 401(k) with employer match
• Profit sharing

The ideal candidate is a self-starter who understands that successful surgical scheduling involves much more than finding an available date. They know how to navigate insurance requirements, anticipate authorization obstacles, coordinate peer-to-peer reviews, and keep cases moving forward.

We are looking for someone who takes ownership, communicates proactively, works efficiently in a fast-paced medical practice, and requires minimal day-to-day oversight once trained.

If you have strong orthopedic scheduling and authorization experience and want to be part of a collaborative specialty practice, we encourage you to apply to join Prime Ortho.