Authorization Representative - St. Petersburg

Florida Orthopaedic Institute; Saint Petersburg (FL); On-site; USD 34,000 - 48,000; Full time

Job summary

Florida Orthopaedic Institute is seeking a Referral and Authorization Coordinator to accurately obtain and document referrals and authorizations for patients. The role involves contacting physician offices, insurance companies, and patients to ensure authorization for physician services, dates of service, and anticipated services.

Responsibilities include coordinating referrals with PCPs/insurers, documenting authorizations, informing patients of potential issues, and collaborating with

Qualifications

• High school graduate.
• 2+ 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.

Responsibilities

• Coordinate with 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 potential problems concerning obtaining authorization prior to scheduled appointment.
• Coordinate with Billing/Collections to research and obtain authorizations on previously denied claims.
• Coordinate with Benefit Verification Rep to confirm benefits when problems occur.
• Use insurance websites (Availity, Humana Military/Tricare, UnitedHealthcare) to obtain referrals/authorizations.
• All other duties as assigned.

Skills

Customer service

Communication

Multi-tasking

Data entry

Education

High school diploma

Tools

Availity

Humana Military (Tricare)

UnitedHealthcare

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.