Healthcare Authorization & Benefits Specialist

Gastro Health; Florida; On-site; USD 35,000 - 55,000; Full time

Job summary

Gastro Health seeks an Authorization and Benefits Coordinator to process referrals, verify member eligibility and benefits, and communicate with providers and health plans. You will coordinate authorizations, request medical records when needed, and support the network and claims teams to resolve issues.

Strong data entry, organizational skills, and knowledge of insurance requirements are essential. This role is office-based in Florida with occasional weekend coverage as needed.

Qualifications

• Knowledge of insurance carrier requirements
• 1 year or more of insurance verification and authorization experience

Responsibilities

• Input requests for services received into the system accurately for electronically generated authorization and tracking.
• Communicates with requesting provider for identified needs to clarify authorization requests, such as CPT/ICD codes and demographics.
• Requests submission of medical records per criteria for requested services.
• Notifies required parties within the appropriate timeframe for routine and urgent requests.
• Researches member history for duplications and authorization limits.
• Provides authorizations to appropriate facilities and forwards them to relevant staff.

Skills

Computer Literate

Customer Service

Data Entry

Effective Communicator

Cross-train

Job description

Gastro Health seeks an Authorization and Benefits Coordinator to process referrals, verify member eligibility and benefits, and communicate with providers and health plans. You will coordinate authorizations, request medical records when needed, and support the network and claims teams to resolve issues.

Strong data entry, organizational skills, and knowledge of insurance requirements are essential. This role is office-based in Florida with occasional weekend coverage as needed.