Ortho Spine Authorization Pro - Pre-Cert & Insurance Benefits

Socket.dev; Melbourne (FL); On-site; USD 42,000 - 65,000; Full time

Job summary

Health First in Florida is seeking an Authorization Specialist to verify insurance eligibility, obtain benefits, and secure pre-certification and referrals before services. You will determine third-party payer requirements and handle authorizations, communicate with insurance companies, physicians, and patients, and maintain compliant, timely documentation.

This full-time role emphasizes confidentiality, HIPAA compliance, and teamwork in a fast-paced healthcare environment.

Qualifications

• High School Diploma or equivalent.
• 2 years’ experience in healthcare insurance authorizations OR
• Proficient in Microsoft Office (Outlook, Word, Excel, PowerPoint).
• Ability to operate and stay organized when using multiple computer screens and function effectively in a call center environment.
• Understanding and ability to apply knowledge of CPT and ICD 10 codes.
• Intermediate medical terminology, and health insurance knowledge.

Responsibilities

• Verifies insurance benefits for customers.
• Notifies customers of deductibles and co-insurance requirements.
• Regularly calls insurance companies to follow up on authorization status.
• Explores other payment options with customers when needed.
• Processes referrals and submits medical records to insurance carriers to expedite prior authorization.
• Manages correspondence with insurance companies, physicians, specialists and patients, ensuring timely documentation.
• Handles incoming and outgoing emails, faxes and phone calls with patients and clinic staff.
• Ensures confidentiality of all health information per HIPAA guidelines.

Skills

Multitasking in call center

CPT ICD-10 knowledge

Medical terminology

Health insurance knowledge

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

Health First in Florida is seeking an Authorization Specialist to verify insurance eligibility, obtain benefits, and secure pre-certification and referrals before services. You will determine third-party payer requirements and handle authorizations, communicate with insurance companies, physicians, and patients, and maintain compliant, timely documentation.

This full-time role emphasizes confidentiality, HIPAA compliance, and teamwork in a fast-paced healthcare environment.