Medical Authorization Specialist

Florida Digestive Health Specialists LLP; Tampa (FL); On-site; USD 42,000 - 56,000; Full time

Job summary

Florida Digestive Health Specialists in Tampa, FL is seeking an Authorization Specialist to secure timely approvals for medical procedures. You will verify coverage with insurers and input data into the EMR, ensuring accurate records for the Central Billing Office and patient communications.

Ideal candidates have 2+ years in medical billing or authorizations, strong communication, and solid knowledge of HIPAA and insurance processes.

Qualifications

• High School Diploma or equivalent.
• Minimum of 2 years' experience in medical billing, insurance verification, or authorization processes.
• Knowledge of healthcare insurance plans, medical terminology, HIPAA regulations, and medical recordkeeping.
• Proficiency in EMR software and basic computer applications (e.g. Microsoft Office).
• Strong organizational skills and attention to detail.
• Excellent communication and interpersonal skills.
• Ability to maintain effective and organized systems to ensure timely patient flow.
• Problem-solving abilities and a proactive approach to tasks.

Responsibilities

• Obtain prior authorizations for medical procedures, treatments, and services by contacting insurance companies and verifying coverage details.
• Accurately enter and update authorization information in the electronic medical record (EMR) system.
• Monitor authorization status and follow up with insurance companies as needed to ensure timely approvals.
• Inform patients of authorization status, coverage details, and any potential out of pocket expenses.
• Work closely with physicians, nurses, and other healthcare providers to gather necessary documentation for authorization requests.
• Collaborate with the Central Billing Office (CBO) to ensure accurate and complete submission of claims.
• Assist billing department with preparation of billing data and medical claim submission to insurance companies.
• Address and resolve any issues or discrepancies related to insurance authorizations.
• Appeal denied authorizations by preparing and submitting appropriate documentation.
• Maintain knowledge of insurance policies, procedures, and regulatory requirements.
• Ensure compliance with all HIPAA regulations and maintain patient confidentiality at all times.
• Other duties as assigned.

Skills

Communication

Organization

Attention to detail

Interpersonal skills

Education

High School Diploma or equivalent

Tools

EMR software

Microsoft Office

Job description

Florida Digestive Health Specialists in Tampa, FL is seeking an Authorization Specialist to secure timely approvals for medical procedures. You will verify coverage with insurers and input data into the EMR, ensuring accurate records for the Central Billing Office and patient communications.

Ideal candidates have 2+ years in medical billing or authorizations, strong communication, and solid knowledge of HIPAA and insurance processes.