Authorization Representative

Team Member Services; Tampa (FL); On-site; USD 22,000 - 35,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

Life insurance

Disability insurance

Paid Time Off from Day One

403-B retirement plan

4 weeks paid parental leave

Career development

Well-being resources

Mental health resources

Pet benefits

Job summary

AdventHealth in Tampa, FL seeks a front-office assistant to provide backup coverage for check-in, check-out and medical records, and to obtain and process authorizations within hospital and clinic settings.

The role requires medical terminology knowledge, insurance verification experience, and proficient use of EMR/EPM systems. Strong communication and reliability are essential for timely authorizations and excellent patient service.

Qualifications

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

Responsibilities

• 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.
• Receives 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 hospital areas 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 helps patients understand financial responsibility.
• Adheres to all policies and procedures.
• Obtains demographic, diagnostic, and insurance information required to request prior authorizations.
• Other duties as assigned.

Skills

Effective communication

Typing 30 wpm and 10-key

Strong organizational skills

Timelines adherence

Multi-tasking

EMR and EPM proficiency

Insurance verification experience

Medical terminology

Customer service experience

Problem solving & attention to detail

ICD-10 & CPT knowledge

Payer requirements knowledge

General computer/data entry skills

Education

High School Grad or Equiv

Tools

EMR system

EPM system

Job description

Our promise to you

Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Benefits and Perks

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule

• Full time
• Shift: Day (United States of America)

Location

3000 Medical Park Dr
City: Tampa
State: Florida
Postal Code: 33613

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.
• Receives 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.
• Adheres to all company policies and procedures.
• Obtains necessary demographic, diagnostic, and insurance information, as well as clinical information required to request prior authorizations.
• Other duties as assigned.

Knowledge, Skills, and Abilities

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

Education

• High School Grad or Equiv [Required]

Work Experience

• 1+ years of authorization experience [Required]
• 3+ insurance verification experience [Required]

Physical Requirements

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range

$15.84 - $25.34

Background Screening Requirement (Florida Law)

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/

Equal Opportunity Employer

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.