Authorization Specialist - USFTGP UMSA RCO Front End

About the role

The Authorization Specialist coordinates and secures insurance pre-certifications and pre-authorizations for medical procedures, outpatient testing, and prescribed medications. This role serves as a liaison between providers, insurance carriers, patients, and external agencies to ensure timely access to care while maintaining complete and accurate documentation within the electronic medical record (EMR).

Responsibilities

• Serves as a liaison between providers, insurance carriers, patients, and external agencies to ensure timely access to care while maintaining complete and accurate documentation within the electronic medical record (EMR).
• Supports continuity of care by facilitating appointments, triaging patient communications, and assisting with peer-to-peer reviews to resolve authorization barriers efficiently.
• Accurately documents clinical, insurance, and authorization details in an electronic medical record to ensure compliance and continuity of care.
• Educates and guides patients through complex authorization processes while delivering a positive, supportive patient experience.
• Manages multiple authorizations, appointments, and deadlines simultaneously in a fast-paced clinical environment.
• Gathers medical necessity documentation, identifies authorization barriers, and supports peer-to-peer review coordination for timely resolution.

Requirements

• High school diploma or GED
• Six (6) months’ medical office experience to include auth/pre-cert.
• Knowledge of medical terminology, CPT & ICD-9 coding.
• Strong written and verbal communication skills to interact effectively with physicians, insurance carriers, patients, and external healthcare organizations.
• Ability to manage multiple authorizations, appointments, and deadlines simultaneously in a fast-paced clinical environment.
• Ability to gather medical necessity documentation, identify authorization barriers, and support peer-to-peer review coordination for timely resolution.

Qualifications

• Understanding of pre-certification, prior authorization, and referral requirements across various payer types, including commercial, Medicare, and Medicaid plans.

Skills

• Technical knowledge, skills, and abilities as outlined above.

Benefits

N/A

Pay

$35,110.40 per year

Schedule

Full-time

Primary Location

Tampa