Authorization Representative

Florida Orthopaedic Institute; Clearwater (FL); On-site; USD 32,000 - 42,000; Full time

Job summary

Florida Orthopaedic Institute is seeking an Authorization Specialist to accurately obtain and document referrals and authorizations for patient visits and services. You will work with physician offices, insurance providers, and patients to ensure timely, compliant authorizations.

The role requires at least a high school diploma and 2+ years in a medical setting, with strong customer service and data entry skills.

Qualifications

• High school diploma required.
• 2+ years of experience in a medical environment.
• Excellent customer service and communication skills.
• Able to multitask and handle high call volumes.
• Excellent data entry skills.

Responsibilities

• Coordinate with primary care physicians and/or insurance companies to obtain referrals prior to patient appointments.
• Ensure all authorizations are properly documented in the system.
• Advise patients of potential problems obtaining authorization before the scheduled appointment.
• Coordinate with Billing/Collections to research and obtain authorizations on denied claims.
• Coordinate with Benefit Verification to confirm benefits when issues occur.
• Use insurance portals (Availity, Humana Military, United Healthcare, etc.) to obtain referrals/authorizations.
• Perform other duties as assigned.

Skills

Customer service

Communication

Multitasking

Data entry

Job description

Position Summary: Responsible for accurately and efficiently obtaining and documenting all referrals and authorizations. Ensures all patients are authorized for the physician, the date of service and all anticipated services. Referrals and Authorizations are obtained by contacting physician’s offices, insurance companies, and/or the patient.

Key Responsibilities:

• Coordinate with appropriate primary care physicians and/or insurance companies to obtain referrals for office visits prior to the patient’s scheduled appointment.
• Ensure all authorizations are properly documented in the system.
• Advise patients of any potential problems concerning obtaining authorization prior to the scheduled appointment.
• Coordinate with the Billing/Collections department to research and obtain authorizations on previously denied claims.
• Coordinate with the Benefit Verification Rep to confirm benefits when problems occur.
• Utilize insurance websites (Availity, Humana Military (Tricare),United Healthcare, etc.) to obtain referrals/authorizations
• All other duties as assigned

Qualifications:

• Candidate must be a high school graduate.
• 2 or more years of experience in a medical environment.
• Excellent customer service and communication skills.
• Able to multi-task and handle high call volumes.
• Excellent Data entry Skills

Orthopaedic Solutions Management is a Drug Free Workplace

We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug-free workplace. All candidates will be required to undergo pre-employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.