Authorization Specialist - USFTGP Dermatology

Tampa General Hospital • Tampa, FL

4d

About The Position

The Authorization Specialist is responsible for coordinating and securing insurance pre-certifications and pre-authorizations for medical procedures, outpatient testing, and prescribed medications. This role serves as a liaison between providers, insurance carriers, patients, and external agencies to ensure timely access to care while maintaining complete and accurate documentation within the electronic medical record (EMR). The Authorization Specialist supports continuity of care by facilitating appointments, triaging patient communications, and assisting with peer-to-peer reviews to resolve authorization barriers efficiently.

Requirements

• High School Diploma or GED
• 6 months medical office experience to include auth/pre-cert
• Knowledge of medical terminology, CPT, and ICD-9 coding
• Excellent communication skills
• Understanding of pre-certification, prior authorization, and referral requirements across various payer types, including commercial, Medicare, and Medicaid plans.
• Ability to accurately document clinical, insurance, and authorization details in an electronic medical record to ensure compliance and continuity of care.
• Strong written and verbal communication skills to interact effectively with physicians, insurance carriers, patients, and external healthcare organizations.
• Ability to educate and guide patients through complex authorization processes while delivering a positive, supportive patient experience.
• Ability to manage multiple authorizations, appointments, and deadlines simultaneously in a fast-paced clinical environment.

Responsibilities

• Coordinating and securing insurance pre-certifications and pre-authorizations for medical procedures, outpatient testing, and prescribed medications.
• Serving as a liaison between providers, insurance carriers, patients, and external agencies to ensure timely access to care.
• Maintaining complete and accurate documentation within the electronic medical record (EMR).
• Facilitating appointments.
• Triaging patient communications.
• Assisting with peer-to-peer reviews to resolve authorization barriers efficiently.
• Gathering medical necessity documentation.
• Identifying authorization barriers.
• Supporting peer-to-peer review coordination for timely resolution.

What This Job Offers

• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees