Authorization Representative

Job Description

Provides backup to all front office positions, including check-in, check-out, and medical records. Obtains authorizations within the hospital and clinic setting. Reviews insurance verification and completes the authorization process within established time frames, accurately entering data into software programs. Reviews coverage authorization and works diligently to meet established timelines, including obtaining authorizations for same-day procedures. Works closely with doctors and team members to support efforts to accomplish authorization/verification for both routine and STAT orders. Arranges and oversees peer-to-peer authorizations between specialists and insurance companies. Requests authorization from insurance companies and hospital departments to provide specific services and parameters of care. Serves as liaison between clinic and specific areas of the hospital to assure timely authorization and provision of services. Provides effective communication to patients, families, team members, and other healthcare professionals while maintaining confidentiality. Assists in correcting claim denials and provides assistance to patients in understanding their financial responsibility.

Knowledge, Skills, and Abilities

• Demonstrated effective communication and interpersonal relation skills
• Demonstrated computer experience using word processing and data entry software
• Must be able to type 30 wpm and know 10-key by touch
• Strong Organizational Skills
• Ability to adhere to strict timelines
• Multi-tasking skills
• Proficiency in EMR and EPM
• Previous insurance verification experience
• Proficiency in Medical Terminology
• Previous customer service work experience
• Problem Solving Skills and Attention to Detail
• Knowledge of ICD-10 and CPT coding
• Knowledge of payer requirements for authorization and billing

Education

• High School Grad or Equiv

Work Experience

• 1+ years of authorization experience
• 3+ insurance verification experience

Additional Information

N/A

Licenses And Certifications

N/A

Physical Requirements

View physical requirements

Pay Range

$15.69 - $25.10

Background Screening Requirement

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/. This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.