Insurance Authorization Specialist II - Patient Access

Nemours-Children; Jacksonville (FL); In loco; USD 52.000 - 66.000; Tempo pieno

Descrizione del lavoro

Nemours is seeking an Insurance Authorization Coordinator II in Jacksonville, FL to manage preauthorizations for hospital- and physician-based services. You will verify insurance coverage, calculate patient financial responsibility, and coordinate with multiple departments to ensure timely authorizations and efficient reimbursements.

The role requires cross-training across workflows, strong communication with patients and providers, and meticulous documentation and compliance to policy and

Competenze

• Obtain preauthorizations for assigned specialties and coordinate for other workflows.
• Verify insurance coverage, eligibility, demographics and financial responsibility.
• Communicate with patients, families and clinicians to update on authorization status.

Mansioni

• Coordinate authorization and referrals to ensure timely approvals.
• Verify payer requirements and submit documentation for authorizations.
• Review clinical docs and submit to payer with authorization requests.
• Maintain accurate records of requests, approvals, denials and related communications.
• Collaborate with physicians, clinical staff and departments to obtain reimbursements.
• Identify barriers in the authorization process and resolve denials or appeals.
• Attend daily huddles to discuss payer issues and workflow blockers.
• Ensure compliance with privacy laws and organizational policies.

Conoscenze

Authorization Coordination

Insurance verification

Communication

Documentation

Collaboration

Problem-solving

Compliance

Formazione

High School Diploma

Descrizione del lavoro

Nemours is seeking an Insurance Authorization Coordinator II in Jacksonville, FL to manage preauthorizations for hospital- and physician-based services. You will verify insurance coverage, calculate patient financial responsibility, and coordinate with multiple departments to ensure timely authorizations and efficient reimbursements.

The role requires cross-training across workflows, strong communication with patients and providers, and meticulous documentation and compliance to policy and