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Authorization Associate 2, Miami Cancer Institute, FT, 10:30A-7P
3 months ago
Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward, and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. Baptist Health is supported by philanthropy and committed to its faith-based charitable mission of medical excellence.
Our mission, vision, and values make us who we are at Baptist Health and are at the center of everything we do. At Baptist Health, we positively impact the human experience for patients, employees, and physicians. Our success comes from a culture of quality and dedication that is instilled into every member of the Baptist Health family.
This year, and for 24 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, based on employee feedback. We’ve also been recognized as one of America’s Most Innovative Companies and People Magazine included us in 50 Companies That Care. Based on the U.S. News & World Report 2023-2024 Best Hospital Rankings, Baptist Health is the most awarded healthcare system in South Florida, with its hospitals and institutes earning 45 high-performing honors.
But really, the reason we’re excited to come to work is the people.
Working together, we form personal connections with our colleagues that are stronger than most of us have experienced at other jobs. We develop caring relationships with our patients and their families that go beyond just delivering healthcare. After all, we know what it’s like to be in their shoes. Many of us have been patients here and have had family members as patients here. We’re committed to delivering quality care in the most compassionate way possible because we feel a personal stake in the outcomes. When it comes to caring for people, we’re all in.
Description:
The incumbent will be responsible to request, follow-up, obtain, and validate authorizations/referrals/notifications with appropriate CPT and ICD-10 codes, within the appropriate timelines. This position requires the incumbent to be in a call center type environment and responsible for meeting individual quality metrics. Responsible for coordinating patient flow, timely processing, maintaining knowledge and deployment of practices used within the department/physician practice/hospital to address patient questions or concerns. Maintaining knowledge of insurance requirements, BHSF pricing, financial assistance options, and overall BHSF Revenue Cycle operations. Assist in supporting go lives and different departmental initiatives, including onboarding and training team members. Participate in departmental committees/champion opportunities. Practices the Baptist Health philosophy of service excellence in providing professional, compassionate and friendly service to patients of all ages, families, employees, physicians and community members.
Qualifications:
High School Diploma, Certificate, GED, training or experience required. Additional Qualifications: For internal staff: A minimum of 2 years experience in validating/obtaining authorizations with insurance payers and has demonstrated the ability to independently perform all functions within the Level 1 job description. Meets/exceeds all Individual Performance Standards for at least the most recent 6 months. Exceeds departmental KPIs and is cross trained in multiple areas/product lines to substitute all staff positions as needed. For external staff: Associates Degree preferred with 2 years experience in validating/obtaining authorizations with insurance payers, or 3 years experience in lieu of degree. Complete and pass the Patient Access training course. Ability to work in a high volume, fast-paced work environment, and perform basic mathematical calculations. Detail oriented, organized, team player, compassionate, excellent customer service and interpersonal communication skills. Desired: Knowledge of healthcare regulatory guidelines to include, but not limited to, HIPAA, AHCA, EMTALA, Medicare coverage structure, including medical necessity compliance guidelines. Understanding of insurance contracts, collections, authorizations, and pre-certifications, Microsoft Office products, and EMR applications, etc. Knowledge of medical terminology. Bilingual English, Spanish/Creole.
EOE
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