Authorization Specialist- Crane Creek Ortho Surgery

Health First • Melbourne, FL

44d

About The Position

The Authorization Specialist verifies eligibility, obtains insurance benefits, and ensures pre-certification, authorization, and referral requirements are met prior to the delivery of outpatient, and ancillary services. The Authorization Specialist will determine which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care.

Requirements

• High School Diploma or equivalent
• Two (2) years' performing Healthcare insurance authorizations OR Two (2) years' in clinical healthcare with background with CPT and ICD-10 codes.
• Proficient in Microsoft Office - Outlook, Word, Excel, PowerPoint.
• Ability to operate and stay organized when using multiple computer screens and website windows and function effectively in a call center environment.
• Understanding and ability to apply knowledge of CPT and ICD 10 codes.
• Intermediate medical terminology, and health insurance knowledge.

Responsibilities

• Handles the verification of insurance benefits for customers.
• Notifies customers of deductibles and co-insurance requirements.
• Regularly calls insurance companies to follow up on status of the authorization.
• Explores other payment options with customer when needed.
• Process referrals and submit medical records to insurance carriers to expedite prior authorization processes in accordance to Health First policy and procedures.
• Manage correspondence with insurance companies, physicians, specialists and patients as required and ensures accurate and timely documentation of these contacts.
• Handles incoming and outgoing emails, faxes and phone calls with patients, clinic staff, insurance providers.
• Ensures confidentiality of all health information as required by Florida State statutes and Health Insurance Portability and Accountability Act (HIPAA) guidelines ensuring compliance.

Benefits

• At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees