Insurance Authorization Specialist

2 days ago

Sarasota FL United States Florida Digestive Health Specialists LLP Full time
Description: The Insurance Authorization Specialist is responsible for ensuring timely and accurate authorization of medical procedures, treatments, and services. This role involves close coordination with healthcare providers, insurance companies, our Central Billing Office (CBO), and patients to verify coverage and secure the necessary approvals to optimize reimbursement and patient satisfaction. The ideal candidate will possess strong communication skills, attention to detail, and a solid understanding of healthcare insurance processes.

Our Culture: Inspire hope. Build your legacy. Discover a rewarding, fulfilling, well-balanced career at Florida Digestive Health Specialist, LLP. With providers and locations across Florida, FDHS is one of the largest single-specialty, physician-owned GI practices in the state. FDHS was established in 2011 to provide comprehensive, high-quality gastroenterology services and foster advanced research for digestive health problems. With a growing team of nationally acclaimed care centers, providers, and staff, we continue to expand our reach to communities that need our care.

Essential Duties:

Obtain prior authorizations for medical procedures, treatments, and services by contacting insurance companies and verifying coverage details.
Accurately enter and update authorization information in the electronic medical record (EMR) system.
Monitor authorization status and follow up with insurance companies as needed to ensure timely approvals.
Inform patients of authorization status, coverage details, and any potential out of pocket expenses.
Work closely with physicians, nurses, and other healthcare providers to gather necessary documentation for authorization requests.
Collaborate with the Central Billing Office (CBO) to ensure accurate and complete submission of claims.
Assist billing department with preparation of billing data and medical claim submission to insurance companies.
Address and resolve any issues or discrepancies related to insurance authorizations.
Appeal denied authorizations by preparing and submitting appropriate documentation.
Maintain knowledge of insurance policies, procedures, and regulatory requirements.
Ensure compliance with all HIPAA regulations and maintain patient confidentiality at all times.
Other duties as assigned. Please note that the duties and responsibilities outlined in this job description are not exhaustive and may be subject to change at any time to meet the evolving needs of the company. In addition to the responsibilities listed above, employees may be required to perform additional tasks or duties as assigned by management.

Qualifications:

High School Diploma or equivalent
Minimum of (2) years’ experience in medical billing, insurance verification, or authorization processes.
Knowledge: Understanding of healthcare insurance plans, medical terminology, HIPAA regulations, and medical recordkeeping best practices.
Proficiency in EMR software and basic computer applications (e.g. Microsoft Office)
Strong organizational skills and attention to detail.
Excellent communication and interpersonal skills.
Ability to maintain effective and organized systems to ensure timely patient flow
Problem-solving abilities and a proactive approach to tasks

Benefits:

Competitive salary commensurate with experience.
Comprehensive benefits package including health insurance, retirement plan, paid time off and paid holidays.
Professional development opportunities
Positive and collaborative work environment

Physical Requirements:

Ability to sit for extended periods. Ability to lift and carry files or boxes weighing up to 20 lbs. Ability to use standard office equipment, such as computers, printers, and copiers.

EEO Statement:

It is the policy of Florida Digestive Health Specialists to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law.

When you join FDHS, you become part of a premier team striving to deliver unparalleled, personalized care while treating patients like family. And at FDHS, our patients are at the heart of everything we do. Join our team at FDHS and make a difference in the lives of our patients and employees alike

  • Insurance Authorization Specialist

    4 weeks ago

    Sarasota, United States Florida Digestive Health Specialists LLP Full time $16 - $17

    Job DescriptionJob DescriptionDescription: The Insurance Authorization Specialist is responsible for ensuring timely and accurate authorization of medical procedures, treatments, and services. This role involves close coordination with healthcare providers, insurance companies, our Central Billing Office (CBO), and patients to verify coverage and secure the...

  • Insurance Authorization Specialist

    4 weeks ago

    Sarasota, Florida, United States Insight Global Full time

    Job OverviewPosition Summary:Insight Global is seeking a qualified individual for the role of Insurance Authorization Specialist. In this position, the selected candidate will be responsible for confirming insurance authorizations for patients who are scheduled to visit or have previously visited one of our outpatient facilities. The ideal candidate will...

  • Authorization Specialist

    6 days ago

    , FL, United States Florida Digestive Health Specialists LLP Full time

    Job Title: Authorization SpecialistWe are seeking a detail-oriented and organized Authorization Specialist to join our team at Florida Digestive Health Specialists LLP.Job SummaryThe Authorization Specialist will be responsible for efficiently coordinating all aspects of patient procedures within our gastroenterology office. This role requires excellent...

  • Authorization Specialist

    4 weeks ago

    Largo, FL, United States Advanced Urology Institute LLC Full time

    Description:Authorization SpecialistThe Authorization Specialist serves in a clerical role and is responsible for verifying patient-eligibility, coordinating benefits, and facilitating insurance coverage, as well as addressing patients' concerns regarding authorization and turnaround.DUTIES:Obtain authorizations for surgical/radiological procedures per...

  • Authorization Specialist

    56 minutes ago

    , TX, United States Prelude Fertility Full time

    Authorization Specialist Job DescriptionPrelude Fertility is seeking a highly skilled Authorization Specialist to join our team. As an Authorization Specialist, you will play a critical role in ensuring that our patients receive the necessary authorizations for their medical treatments.Key Responsibilities:Eligibility Verification: Verify patient eligibility...

  • Authorization Specialist

    6 days ago

    , TX, United States Sports Medicine Associates of San Antonio Full time

    Job SummaryWe are seeking a highly skilled Authorization Specialist to join our team at Sports Medicine Associates of San Antonio. As an Authorization Specialist, you will play a critical role in ensuring seamless patient care by managing prior authorizations, verifying insurance benefits, and communicating with payers.Key ResponsibilitiesInterpret and...

  • Authorization Specialist

    5 days ago

    , TN, United States Traditions Health Full time

    Job Title: Authorization SpecialistThe Authorization Specialist plays a crucial role in ensuring the smooth operation of our medical office. This position is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial, insurance-managed Medicare Advantage plans and other...

  • Authorization Specialist

    1 week ago

    Tampa, FL , USA, United States CarepathRx Full time

    Job Title: Authorization SpecialistCarepathRx is a leading healthcare company that transforms hospital pharmacy into a revenue generator through innovative technology and services. We are seeking an experienced Authorization Specialist to join our team.Job Summary:The Authorization Specialist will be responsible for obtaining initial prior authorization and...

  • Authorization Specialist

    4 months ago

    Tacoma, WA, United States Olympic Sports & Spine Full time

    Medical Insurance Authorization SpecialistOlympic Sports & Spine (OSS) is looking for a full-time, experienced medical insurance benefits Authorization Specialist for our growing, fast-paced medical billing office.Olympic Sports & Spine (OSS) is known for its fun and energetic work environment and for valuing its employees. We offer a comprehensive benefits...

  • Authorization Specialist

    6 days ago

    , CA, United States TEKsystems Full time

    Authorization Coordinator Job DescriptionThe Authorization Coordinator position is responsible for ensuring seamless patient care by verifying patient eligibility, coordinating benefits, and determining insurance coverage. This role requires strong communication and organizational skills to facilitate responses to patient and provider inquiries regarding...

  • Authorization Specialist

    2 weeks ago

    Tallahassee, FL , USA, United States Centene Corporation Full time

    Job SummaryCentene Corporation is seeking a highly skilled Authorization Specialist to join our Medical Management/Health Services team. As a key member of our team, you will play a critical role in supporting the prior authorization process, ensuring timely and accurate documentation of authorization requests, and maintaining compliance with contractual...

  • Authorization Specialist

    2 weeks ago

    , NH, United States MaineHealth Full time

    Job SummaryWe are seeking a skilled Authorization Specialist to join our team at MaineHealth · Primary Care. As a key member of our clinical team, you will play a critical role in ensuring seamless patient care by facilitating pre-authorization requests for surgical procedures, radiology, durable medical equipment, and prescriptions.Key...

  • Prior Authorization Specialist

    4 days ago

    , WI, United States Neuroscience Group Full time

    Job Title: Prior Authorization SpecialistWe are seeking a highly skilled Prior Authorization Specialist to join our Clinical Services Team at Neuroscience Group of Northeast Wisconsin S.C.Key Responsibilities:Collect and verify patient insurance information to ensure accurate pre-authorizationReview clinical documentation to determine medical necessity for...

  • Authorization Specialist

    2 weeks ago

    , FL, United States SPECIALTY RX FL LLC Full time

    About SpecialtyRx FL LLCSpecialtyRx FL LLC is a leading Long-Term Care pharmacy dedicated to providing exceptional pharmaceutical services to long-term care facilities and assisted living communities. Our team takes pride in delivering personalized care and quality pharmacy services.Job SummaryWe are seeking an experienced Authorization Representative to...

  • Pre-Authorization Specialist

    4 days ago

    , GA, United States Ortho Sport and Spine Physicians Full time

    Job OverviewOrtho Sport and Spine Physicians is seeking a detail-oriented Pre-Authorization Specialist to manage insurance pre-authorizations for various services, ensuring timely care for patients.Key ResponsibilitiesSubmit and track authorization requests with insurance companies for procedures such as MRI, spine interventions, surgeries, and durable...

  • Radiology Authorization Specialist

    4 weeks ago

    Denver, CO, United States Together Women's Health, LLC Full time

    Overview:The Women's Imaging Center, a proud partner of Together Women's Health, is expanding its medical team and seeking a dynamic full-time MRI Authorization Specialist. Located in the heart of Cherry Creek/Denver, our state-of-the-art facility at 3773 Cherry Creek North Dr, Suite 101, Denver, CO 80209 is dedicated to providing exceptional care to our...

  • Authorization Specialist III

    2 weeks ago

    Colorado Springs, CO, United States VirtualVocations Full time

    A company is looking for an Authorization Specialist III to support the prior authorization request process in the utilization management team. Key Responsibilities Track and maintain authorization requests in accordance with insurance guidelines Verify member insurance coverage and perform data entry for complex authorization requests Act as a...

  • Medical Authorization Representative

    4 weeks ago

    Garden City, NY, United States Orlin & Cohen Medical Specialist Group Full time

    Orlin & Cohen is one of the largest orthopedics practices in the region, with 20 offices in Nassau and Suffolk Counties, Queens, and Staten Island. We have been in business for more than 25 years and have over 1200 dedicated healthcare employees in our care. Team members enjoy competitive salaries, exceptional medical benefits, and generous PTO.We are...

  • Medical Authorization Representative

    2 days ago

    Garden City, NY, United States Orlin & Cohen Medical Specialist Group Full time

    Orlin & Cohen is one of the largest orthopedics practices in the region, with 20 offices in Nassau and Suffolk Counties, Queens, and Staten Island. We have been in business for more than 25 years and have over 1200 dedicated healthcare employees in our care. Team members enjoy competitive salaries, exceptional medical benefits, and generous PTO.We are...

  • Prior Authorization Specialist

    2 weeks ago

    San Diego, CA, United States VirtualVocations Full time

    A company is looking for a Prior Authorization Specialist to manage authorization requests for outpatient diagnostic and surgical services. Key Responsibilities Determine authorization requirements and escalate cases as needed Submit authorization requests and gather clinical data for insurance companies Follow up with physician offices and patients...