Healthcare Authorization Specialist — Pre-Cert & Benefits

Health First; Melbourne (FL); Presencial; USD 25.000 - 39.000; Jornada completa

Descripción de la vacante

Health First in Melbourne, FL is seeking an Authorization Specialist to verify insurance eligibility, obtain benefits, and secure pre-certifications for outpatient services. The role requires coordinating with insurers, clinicians, and patients, ensuring timely authorizations in line with Health First policies.

The candidate should have a high school diploma, 2 years of experience in healthcare insurance authorizations or CPT/ICD-10 background, and proficiency in Microsoft Office.

Formación

• Education: High School Diploma or equivalent.
• Two years’ healthcare insurance authorizations OR two years’ clinical healthcare with CPT and ICD-10 experience.
• L icensure: None
• Certification: None
• Proficient in Microsoft Office – Outlook, Word, Excel, PowerPoint.
• Ability to operate and stay organized with multiple screens in a call center setting.
• Understanding CPT and ICD-10 and health insurance concepts.

Responsabilidades

• Verify insurance benefits for customers.
• Notify customers of deductibles and co-insurance requirements.
• Call insurance companies to follow up on authorization status.
• Explore other payment options with customers when needed.
• Process referrals and submit medical records for prior authorization.
• Manage correspondence with insurers, physicians, and patients.
• Handle emails, faxes, and calls while ensuring HIPAA compliance.

Conocimientos

Medical terminology

Insurance knowledge

Organization skills

HIPAA compliance understanding

Educación

High School Diploma or equivalent

Herramientas

Microsoft Office

Descripción del empleo

Health First in Melbourne, FL is seeking an Authorization Specialist to verify insurance eligibility, obtain benefits, and secure pre-certifications for outpatient services. The role requires coordinating with insurers, clinicians, and patients, ensuring timely authorizations in line with Health First policies.

The candidate should have a high school diploma, 2 years of experience in healthcare insurance authorizations or CPT/ICD-10 background, and proficiency in Microsoft Office.