Authorization Representative

AdventHealth; Tampa (FL); On-site; USD 22,000 - 35,000; Full time

Job summary

AdventHealth Tampa is hiring an Authorization Clerk to support front-line clinical operations by obtaining authorizations, verifying insurance, and coordinating with doctors and departments to ensure timely coverage.

You will communicate with patients and families, review payer requirements, and maintain confidentiality while meeting tight timelines; requires experience in medical terminology and EMR systems.

Qualifications

• Demonstrated effective communication and interpersonal skills.
• Must be able to type 30 wpm and know 10-key by touch.
• Strong organizational skills and ability to adhere to strict timelines.
• Experience in medical terminology and insurance verification.
• Knowledge of ICD-10 and CPT coding and payer requirements.

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.
• Receives coverage authorization and works to meet timelines, including same-day procedures.
• Works with doctors and team members to support authorization/verification for routine and STAT orders.
• Requests authorization from insurance companies and hospital departments for specific services and care parameters.

Skills

Communication skills

Data entry

Typing 30 wpm

10-key by touch

Organizational skills

Timelines

Multi-tasking

EMR

EPM

Insurance verification

Medical terminology

Customer service

Problem solving

Attention to detail

ICD-10 & CPT knowledge

Payer requirements knowledge

Education

High School Grad or Equiv

Tools

EMR

EPM

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.

All the benefits and perks you need for you and your family

• 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)

Address

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

(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/

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