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Authorization Specialist

2 months ago

Jacksonville, Florida, United States Center for Orthopedic and Research Excel Full time
Job Overview

At Center for Orthopedic and Research Excel, we pride ourselves on being a leading provider in orthopedic care. Our commitment is to ensure that exceptional orthopedic services are accessible to all patients, both now and in the future.

We are currently seeking a Prior Authorization Specialist to join our dedicated team. This role is crucial in facilitating the pre-registration and authorization processes, ensuring that all necessary information is accurately gathered before patient appointments.

Key Responsibilities
  • Conduct pre-registration and eligibility verification for patients.
  • Communicate effectively with patients and insurance providers to gather necessary demographic and reimbursement information.
  • Obtain benefit verifications and required authorizations.
  • Utilize online verification systems to confirm insurance eligibility in real-time.
  • Create referrals for pending visits and ensure accurate processing of claims.
  • Address inquiries from healthcare providers and support staff regarding the status of prior authorizations.
Qualifications
  • High school diploma or equivalent required.
  • Two to three years of experience in a healthcare setting, specifically in prior authorization.
  • Strong communication skills to interact with physicians, patients, and insurance representatives.
  • Experience with Managed Care Insurance and verification of benefits is essential.
  • Comprehensive understanding of Medicaid and commercial insurance requirements.
Skills and Abilities
  • Detail-oriented with excellent organizational skills.
  • Able to manage multiple tasks in a fast-paced environment.
  • Proficient in typing with a minimum speed of 45 words per minute.
Work Environment

This position is based in a standard office environment, requiring both sitting and standing, along with some bending and stretching. Manual dexterity for computer use is necessary.

Note: This job description serves as a guideline for the essential functions and requirements of the role. Responsibilities and qualifications may evolve as the needs of the organization change.