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Authorization Representative Primary Care
2 months ago
All the benefits and perks you need for you and your family:
Benefits from Day One
Paid Days Off from Day One
Career Development
Whole Person Wellbeing Resources
Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind, and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: M-F
Shift : Day
Location : 10987 SHELDON ROAD, #200, Tampa, 33626
The community youll be caring for:
Join a team that provides exceptional patient-based care.
Collaborative teams that work together for a common goal
Compassionate and supportive leaders ensure work life balance for team members and providers without compromising patient care.
The role youll contribute: Insurance Authorization Specialist will work as a liaison with Hospital Authorization departments to obtain insurance verification, notification, pre-certification, authorization and obtaining reference numbers (as appropriate) for all patients undergoing surgical procedures, endoscopic procedures, testing and infusions within the hospital as well as clinic setting. Insurance Authorization Specialist will work closely with all members of the physicians teams to assure timely and accurate authorization for both routine and stat items. This individual must possess basic clinical knowledge and terminology and must be able to effectively communicate with and support multiple doctors/specialists, APPs and team members. This individual must be able to work in a fast pace, changing environment. This individual must also be able to identify problems and communicate with the members of the Revenue Cycle team (Coders, Patient Account Reps, Coding and AR Supervisors) and insurance companies in a timely manner.
The value youll bring to the team:
- Obtains and/or works with Hospital Departments to obtain authorizations in a timely manner for endoscopic procedures, surgical procedures, radiology and laboratory testing, infusions and visits within the hospital and clinic setting.
- Reviews the insurance verification and completes the authorization process within established time frames. Accurately enters data into software program.
- Receives coverage authorization and works diligently to meet established timelines; may be required to obtain authorizations for same day procedures.
- Works closely with doctors, APPs and team members to support efforts to accomplish authorization/verification for both routine and STAT orders.
- Routinely arrange and oversee peer to peer authorizations between specialists and insurance companies.
- Requests authorization from insurance company/Hospital Department to provide specific services and parameters of care.
- Serves as liaison between
The expertise and experiences youll need to succeed:
Minimum qualifications:
- High School diploma, or equivalent
- 3-5 years of Insurance Verification Experience plus 1-2 years of Authorization experience
- Problem Solving Skills and Attention to Detail
- Proficiency in EMR and EPM
- Previous insurance verification experience
- Knowledge of ICD-10 and CPT coding
- Knowledge of payer requirements for authorization and billing
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
Category: Patient Financial Services
Organization: AdventHealth Medical Group Primary Care
Schedule: Full-time
Shift: 1 - Day
Req ID: 24024019
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.
