Authorization Specialist- USFTGP UMSA RCO Front End

Tampa-General-Hospital; Tampa (FL); On-site; USD 42,000 - 66,000; Full time

Job summary

Tampa General Hospital is seeking an Authorization Specialist to coordinate and secure pre-certifications and pre-authorizations for procedures, tests, and medications. You will act as a liaison between providers, insurance carriers, patients, and external agencies to ensure timely access to care with accurate EMR documentation.

Responsibilities include triaging patient communications, coordinating appointments, and assisting with peer-to-peer reviews to overcome authorization barriers

Qualifications

• High School Diploma or GED is required.
• Five (5) years of relevant medical office experience to include auth/pre-cert.
• Knowledge of medical terminology and CPT & ICD-9 coding.
• Excellent written and verbal communication skills.

Responsibilities

• Coordinate and secure insurance pre-certifications and pre-authorizations for procedures, tests, and medications.
• Serve as liaison between providers, insurance carriers, patients, and external agencies to ensure timely access to care.
• Document all authorization details accurately in the EMR to ensure compliance and continuity of care.
• Facilitate appointments, triage patient communications, and assist with peer-to-peer reviews to resolve barriers.

Skills

Pre-certification knowledge

Authorizations management

Medical terminology

CPT & ICD-9 coding

Communication skills

EMR documentation

Education

High School Diploma or GED

Job description

Job Description - Authorization Specialist- USFTGP UMSA RCO Front End (260004E1)

Job Description

Authorization Specialist- USFTGP UMSA RCO Front End - ( 260004E1 )

Description

The Authorization Specialist is responsible for coordinating and securing insurance pre-certifications and pre-authorizations for medical procedures, outpatient testing, and prescribed medications. This role serves as a liaison between providers, insurance carriers, patients, and external agencies to ensure timely access to care while maintaining complete and accurate documentation within the electronic medical record (EMR). The Authorization Specialist supports continuity of care by facilitating appointments, triaging patient communications, and assisting with peer-to-peer reviews to resolve authorization barriers efficiently.

Qualifications

Required:

High School Diploma or GED

Work Experience and Additional Information

Five (5) years of relevant medical office experience to include auth/pre-cert. Knowledge of medical terminology, CPT & ICD-9 coding. Excellent communication skills

Technical Knowledge, Skills and Abilities

Understanding of pre-certification, prior authorization, and referral requirements across various payer types, including commercial, Medicare, and Medicaid plans.

Ability to accurately document clinical, insurance, and authorization details in an electronic medical record to ensure compliance and continuity of care.

Strong written and verbal communication skills to interact effectively with physicians, insurance carriers, patients, and external healthcare organizations.

Ability to educate and guide patients through complex authorization processes while delivering a positive, supportive patient experience.

Ability to manage multiple authorizations, appointments, and deadlines simultaneously in a fast-paced clinical environment.

Skill in gathering medical necessity documentation, identifying authorization barriers, and supporting peer-to-peer review coordination for timely resolution.