Authorization Specialist - On Site

Eye-Site-of-Tampa-Bay; Clearwater (FL); On-site; USD 36,000 - 54,000; Full time

Benefits offered by this job

PTO

Health insurance

Dental insurance

401k

Job summary

Eye Site of Tampa Bay is seeking an Authorization Specialist for an on-site, full-time role in Clearwater. The candidate verifies insurance eligibility, secures referrals and prior authorizations, and assists in front desk, optical and billing tasks.

The position emphasizes accurate communication with patients and payers in a fast-paced ophthalmology environment. You will use Availity, UHC/Humana Military portals and a Nextech/MDI PM system.

Qualifications

• Experience in insurance eligibility, prior authorizations and referrals in a health care setting.
• Knowledgeable in use of Availity, UHC Provider/Humana Military websites.
• Knowledgeable of CPT/ICD-10 coding; ophthalmology experience, a plus.
• Detail-oriented with excellent organizational and time management skills.
• Excellent communication skills, both verbal and written.
• Proficiency with Microsoft Word and Excel.
• Positive attitude and demeanor.
• Ability to work in a fast-paced environment.

Responsibilities

• Verify insurance eligibility and benefits using Availity and payer sites.
• Obtain routine eye benefit authorizations.
• Contact carriers to verify coverage and limits.
• Initiate financial agreements for high-deductible plans and co-insurances.
• Obtain appropriate prior authorizations for date of service and procedures.
• Notify patients of balance due and explain coverage limits.
• Document all communications in the Practice Management system.
• Provide coverage for Front Desk and assist in billing projects.
• Support team in research and resolution of claim issues.

Skills

Insurance eligibility

Prior authorizations

Referrals

Detail-oriented

Communication

Tools

Availity

UHC Provider/Humana Military

Nextech/MDI

Microsoft Word

Excel

Job description

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.

Description

On-Site position only. Eye Site of Tampa Bay is a multi-specialty ophthalmology practice focused on excellence in patient care and creating exceptional patient experiences. We offer great pay and benefits in an exceptional team work environment. The Authorization Specialist is the primary source for verifying insurance eligibility and benefits, securing referrals and prior-authorizations, creating predictive financial agreements, and assisting in other Front Desk, Optical and Billing projects. Exciting opportunity! M-F, days, EOE.

• Uses eligibility tools, and is capable of checking benefits through Availity, UHC Provider/Humana Military and other payer websites.
• Obtains routine eye benefit authorizations.
• Contacts insurance carriers to verify coverage and limits as directed by policy.
• Initiates financial agreements for high-deductible health plans and co-insurances.
• Obtains appropriate prior authorizations relevant to date of service and procedure, including same day/add-on procedures, surgeries and testing.
• Contacts patients regarding balance due at time of service, and effectively communicates insurance coverage limits to patients.
• Documents all communication with patients in Practice Management system.
• Provides coverage for Front Desk, as scheduled.
• Participate fully as a team member in a dynamic, patient-focused, fast-paced environment.
• Researches accounts, and works with billing team to resolve claim issues.
• Participates and assists in in-house collection projects, as assigned.
• Participates and assists in special billing projects, as assigned.

Required Skills & Abilities

• Experience in insurance eligibility, prior authorizations and referrals in a health care setting.
• Knowledgeable in use of Availity, UHC Provider/Humana Military websites.
• Knowledgeable of CPT/ICD-10 coding; ophthalmology experience, a plus.
• Detail-oriented with excellent organizational and time management skills.
• Excellent communication skills, both verbal and written.
• Proficiency with Microsoft Word and Excel.
• Positive attitude and demeanor.
• Ability to work in a fast-paced environment.
• Experience using a PM and EHR system (Nextech/MDI,a plus).
• Must be able to pass background and drug screening.

• Excellent benefit package to include PTO, health/dental insurance, 401k. Outstanding work environment. Salary commensurate with experience.

Position Requirements

Full-Time/Part-Time Full-Time

May require travel between offices.

Position Patient Collections Specialist

Location Eye Site of Tampa Bay - Clearwater

This position is currently accepting applications.