Healthcare Referral & Authorization Specialist

Socket.dev; Tampa (FL); On-site; USD 34,000 - 42,000; Full time

Job summary

Socket.dev is seeking a Medical Assistant for coordinating referral authorizations between providers and insurance plans in Florida. The role initiates preventive and Health Risk Assessments and assists clients with transfers to CHI as their Primary Care Provider, while providing general information on benefit coverage.

Education includes a high school diploma or GED and completion of an approved Medical Assistant program; CMA/RMA is preferred with CPR certification.

Qualifications

• High school diploma or GED; Medical Assistant program preferred.
• Two to three years experience can substitute for certification.
• CMA or RMA certification preferred; CPR certification required.
• Knowledge of Medicaid benefits/limitations and HMO contracts; familiarity with ICD-10 and CPT codes.
• Typing 20–30 WPM and basic computer skills.
• Bilingual English/Spanish or Creole preferred.

Responsibilities

• Process authorization requests for emergency, specialty and ancillary services for managed care enrollees.
• Ensure referral request forms are completed accurately and processed timely.
• Enter referral authorizations into the system for all CHI clients.
• Complete a minimum of 30 referrals per day, on the front end.
• Respond to inquiries about coverage, benefits, appointments, referrals, etc.

Skills

Medical Terminology

Keyboard

Medicaid coverage benefits

HMO contracts

ICD10 and CPT Codes

Typing 20-30 WPM

Bilingual (EN/ES/Creole)

Education

High School Diploma or GED

Medical Assistant Program

CMA/RMA preferred

Tools

Electronic Medical Records (EMR)

Job description

Socket.dev is seeking a Medical Assistant for coordinating referral authorizations between providers and insurance plans in Florida. The role initiates preventive and Health Risk Assessments and assists clients with transfers to CHI as their Primary Care Provider, while providing general information on benefit coverage.

Education includes a high school diploma or GED and completion of an approved Medical Assistant program; CMA/RMA is preferred with CPR certification.