Authorization Specialist

4 weeks ago


Melbourne, United States Health First Full time

POSITION SUMMARY:

Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of outpatient, and ancillary services. This position determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care.

PRIMARY ACCOUNTABILITIES:

Handles the verification of insurance benefits for customers.  Notifies customers of deductibles and co-insurance requirements. Regularly calls insurance companies to follow up on status of the authorization.  Explores other payment options with customers when needed.  Applies detailed knowledge of ICD10 and CPT codes.  Process referrals and submit medical records to insurance carriers to expedite prior authorization processes in accordance to Health First policy and procedures  Manage correspondence with insurance companies, physicians, specialists and patients as required and ensure accurate and timely documentation of these contacts.  Handles incoming/outgoing emails, faxes and phone calls with patients, clinic staff, insurance providers.  Achieve individual productivity and quality metrics set by management.  Ensures confidentiality of all health information as required by Florida Statutes and HIPAA guidelines ensuring compliance.

Qualifications

QUALIFICATIONS REQUIRED:

MINIMUM QUALIFICATIONS REQUIRED

E ducation: High School or GED Work Experience: Two (2) years performing healthcare insurance authorizations OR Two (2) years as a clinical healthcare provider with background using CPT and ICD 10 codes Specific Knowledge/Skills/Abilities: 
Working knowledge of Microsoft Office – Outlook, Word, Excel. Intermediate keyboarding skills. Understanding of CPT codes and ICD 10 numbers. Intermediate medical terminology. Basic insurance knowledge. Able to operate and stay organized when using multiple computer screens and website windows and function effectively in a call center environment.

PHYSICAL DEMANDS: Sedentary Work: 

Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body.  Sedentary work involves sitting most of the time.  Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.

Job :

Clinic Clerical Support

Organization :

Health First Medical Group LLC

Primary Location :

United States- Florida - Brevard County- Melbourne

Schedule :

Full-time

Shift Times :

8:00 am - 4:30 pm

Job Level :

Associate

  • Melbourne, United States Health First Full time

    **Description**: ***: Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of outpatient, and ancillary services. This position determines which patient services have third party payer requirements and is responsible for obtaining the...


  • Melbourne, United States Health First Full time

    *POSITION SUMMARY: * Responsible for verifying eligibility, obtaining insurance benefits, and ensuring precertification, authorization, and referral requirements are met prior to the delivery of outpatient, and ancillary services. This position determines which patient services have third party payer requirements and is responsible for obtaining the...


  • Melbourne, United States Health First Full time

    **Description**: ***: Responsible for verifying eligibility, obtaining insurance benefits, and ensuring precertification, authorization, and referral requirements are met prior to the delivery of outpatient, and ancillary services. This position determines which patient services have third party payer requirements and is responsible for obtaining the...


  • Melbourne, United States Health First Full time

    POSITION SUMMARY: Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of outpatient, and ancillary services. This position determines which patient services have third party payer requirements and is responsible for obtaining the necessary...


  • Melbourne, United States Health First Full time

    POSITION SUMMARY: Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of outpatient, and ancillary services. This position determines which patient services have third party payer requirements and is responsible for obtaining the...


  • Melbourne, United States Premier Plastic Surgery Partners LLC Full time

    Job DescriptionJob DescriptionJoin us at Clevens Face and Body Specialists! As Brevard's premier growing provider of Plastic Surgery, Botox and fillers, permanent hair restoration, laser treatments, nonsurgical body contouring, laser hair removal, skin cancer care and medical-grade skin care, you will have the opportunity to work with highly educated...


  • Melbourne, United States Premier Plastic Surgery Partners LLC Full time

    Job DescriptionJob DescriptionJoin us at Clevens Face and Body Specialists! As Brevard's premier growing provider of Plastic Surgery, Botox and fillers, permanent hair restoration, laser treatments, nonsurgical body contouring, laser hair removal, skin cancer care and medical-grade skin care, you will have the opportunity to work with highly educated...


  • Melbourne, United States Brevard Public Schools Full time

    Brevard Public Schools is seeking a dedicated and experienced **School Safety and Security Specialist **at area schools. The School Safety and Security Specialist supports the District goals of the safety and security of students, employees, and visitors to the assigned school site by timely and proactively identifying potential security concerns and...


  • Melbourne, United States Bastion Technologies Full time

    Job DescriptionJob DescriptionThe Cybersecurity Specialist will support the Space Force contract at the Patrick Space Force Base in Florida.RESPONSIBILITIES:Provide Cybersecurity (CS) support to the Launch and Test Range System (LTRS) across the Enterprise. Participate in managing the LTRS Access Management Plan (LAMP) effort across the Range.Participate and...


  • Melbourne, United States Brevard Prevention Coalition, Inc. Full time

    **I. Position Concept**: This position will coordinate and facilitate community-based and parent education services primarily at community centers or similar venues. Serves as a point of contact at the community centers and for other similar stakeholders, facilitating ongoing communication with their respective leads. Coordinates implements, and/or creates...


  • Melbourne, United States Percepta Full time

    Job DescriptionJob DescriptionRequisition Title: ESP Prior Approval Escalation Review Specialist (03X7F)US-FL-MelbourneDescription ESP Prior Approval Escalation Review SpecialistAt Percepta, we bring first-class service across each market we support. As a ESP Prior Approval Escalation Review Specialist in Melbourne, Florida, you’ll be a part of...


  • Melbourne, United States Percepta Full time

    Requisition Title :ESP Prior Approval Escalation Review Specialist(03X7F)US-FL-Melbourne Description ESP Prior Approval Escalation Review Specialist At Percepta, we bring first-class service across each market we support. As a ESP Prior Approval Escalation Review Specialist in Melbourne, Florida , you’ll be a part of creating and delivering...


  • Melbourne, United States Percepta Full time

    ESP Prior Approval Escalation Review Specialist At Percepta, we bring first-class service across each market we support. As a ESP Prior Approval Escalation Review Specialist in Melbourne, Florida, youll be a part of creating and delivering amazing customer experiences, while also enjoying the satisfaction of being part of a unique culture. Prior Approval...


  • Melbourne, United States Percepta Full time

    ESP Prior Approval Escalation Review Specialist At Percepta, we bring first-class service across each market we support. As a ESP Prior Approval Escalation Review Specialist in Melbourne, Florida, you'll be a part of creating and delivering amazing customer experiences, while also enjoying the satisfaction of being part of a unique culture. Prior Approval...


  • Melbourne, United States Percepta Full time

    ESP Prior Approval Escalation Review Specialist At Percepta, we bring first-class service across each market we support . As a ESP Prior Approval Escalation Review Specialist in Melbourne, Florida , you'll be a part of creating and delivering amazing customer experiences, while also enjoying the satisfaction of being part of a unique culture. Prior...


  • Melbourne, Florida, United States KPMG US Full time

    Job Description:The KPMG Advisory practice is currently our fastest growing practice. We are seeing tremendous client demand, and looking forward we don't anticipate that slowing down. In this ever-changing market environment, our professionals must be adaptable and thrive in a collaborative, team-driven culture. At KPMG, our people are our number one...


  • Melbourne, United States IASIS Healthcare Full time

    Billing Specialist/Front Desk - Full TimeClick Here to Apply OnlineJob DescriptionLocation: Melbourne Regional Medical CenterPosted Date: 11/14/2023About Steward Health CareNearly a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more...


  • Melbourne, Florida, United States Childrens Home Society of Florida Full time

    Overview:Since opening our doors in 1902, CHS became a part of Florida's history. CHS has been committed to growing and evolving to provide the right services and solutions to address the needs of children and families throughout the changing times. Every day, our team works with parents and kids to empower them and encourage them. With innovative technology...


  • Melbourne, United States Farah & Farah Full time

    Overview Farah & Farah is committed to being the premier personal injury law firm in Southeast GA and throughout Florida by guiding our valued clients through the complex legal system to deliver justice for those who need it most. Our Mission - Relentless dedication to justice for our clients, delivered with uncompromising support, professionalism,...


  • Melbourne, United States Extant Aerospace Full time

    DescriptionThe Company: Employees at Extant Aerospace enjoy working in a dynamic environment, with opportunities for growth, development, and to make a difference. Our unique business model provides ample opportunity to learn and broaden skill sets, or step up to be considered for promotions within the business. We focus on creating a culture and a team that...