Authorization Representative - DME

Florida Orthopaedic Institute; Clearwater, Northern (FL, KY); Hybrid; USD 36,000 - 52,000; Full time

Job summary

Florida Orthopaedic Institute in Clearwater, FL is seeking a Referral and Authorization Coordinator to accurately obtain and document referrals and patient authorizations for the physician and scheduled services. You will contact physician offices, insurers, and patients to secure approvals.

Responsibilities include coordinating with primary care physicians and insurers for durable medical equipment authorizations; ensuring all authorizations are properly documented; informing patients of

Qualifications

• High school diploma required.
• 2+ years in a medical environment.
• Excellent customer service and communication skills.
• Able to multi-task and handle high call volumes.

Responsibilities

• Coordinate with physicians and insurance companies to obtain authorization for durable medical equipment.
• Ensure all authorizations and benefits are documented in the system.
• Advise patients of potential problems obtaining authorization prior to appointments.
• Collaborate with Billing/Collections to research and obtain authorizations on denied claims.
• Utilize insurer portals (Availity, Humana Military, UnitedHealthcare) to obtain referrals/authorizations.
• Perform other duties as assigned.

Skills

Customer service

Communication

Multitasking

Education

High school diploma

Tools

Availity

Humana Military (Tricare)

UnitedHealthcare

Job description

Morton Plant 301 | FOI Clearwater
430 Morton Plant
Suite 301
Clearwater, FL 33756, USA

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 authorization for durable medical equipment.
• Ensure all authorizations and benefits 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.
• 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.

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.