MS/Prior Authorization Spec

Tallahassee Memorial Healthcare • Tallahassee, FL

7d

About The Position

Manages the prior authorization process for medical procedures, treatments, and medications, using a proactive approach to support prompt approvals and smooth patient care. The role maintains documents and records, verifies insurance coverage, collaborates with healthcare providers, physicians, and clinical staff, and audits documents for regulatory compliance. It also requires understanding diversity, demonstrating TMH’s I CARE values—integrity, compassion, accountability, respect, and excellence—and contributing to a safe environment for colleagues, visitors, and patients. Performs miscellaneous duties.

Reports to the MS (Medicus Select)/Director Operations. The position supervises no one.

Requirements

• High school diploma or equivalent, such as a certificate of high school equivalency.
• Two years of relevant, job-related work experience.

Nice To Haves

• Vocational certificate or associate degree in a healthcare, education, information science, or related field.
• Two years of experience with Allscripts Practice Management (PM) and Electronic Health Records (EHR) and/or in insurance, billing, and collections.
• Clinical background or experience in a medical setting.
• Knowledge of charges, payments, and collections.
• Knowledge of Allscripts.
• Ability to multitask effectively.
• Very meticulous.

Responsibilities

• Manage prior authorizations for medical procedures, treatments, and medications.
• Maintain documents and records.
• Verify insurance coverage.
• Collaborate with healthcare providers, physicians, and clinical staff members.
• Audit documents to ensure regulatory compliance.
• Display an understanding of diversity.
• Demonstrate integrity, compassion, accountability, respect, and excellence (I CARE values).
• Contribute to a safe environment for colleagues, visitors, and patients.
• Perform miscellaneous duties.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED