Patient Access Specialist: Referrals & Authorizations

Florida Orthopaedic Institute; Town of Florida, Northern (NY, KY); Hybrid; USD 32,000 - 42,000; Full time

Job summary

Orthopaedic Solutions Management in Saint Petersburg, FL is seeking an Authorization Representative to accurately obtain and document referrals and pre-authorizations for patients. The role requires coordinating with physicians, insurance companies, and patients to ensure authorization for doctors, dates of service, and anticipated procedures.

The ideal candidate has 2+ years in a medical environment, strong communication, and the ability to manage multiple tasks in a fast-paced setting.

Qualifications

• Candidate must be a high school graduate.
• 2 or more years of experience in a medical environment.
• Excellent customer service and communication skills.
• Able to multi-task and handle high call volumes.

Responsibilities

• Coordinate with appropriate primary care physicians and/or insurance companies to obtain referrals for office visits prior to the patient’s scheduled appointment.
• Ensure all authorizations are properly documented in the system.
• Advise patients of any potential problems concerning obtaining authorization prior to the scheduled appointment.
• Coordinate with the Billing/Collections department to research and obtain authorizations on previously denied claims.
• Coordinate with the Benefit Verification Rep to confirm benefits when problems occur.
• Utilize insurance websites (Availity, Humana Military (Tricare),United Healthcare, etc.) to obtain referrals/authorizations
• All other duties as assigned

Skills

Customer service

Communication

Multitasking

Education

High school diploma

Job description

Orthopaedic Solutions Management in Saint Petersburg, FL is seeking an Authorization Representative to accurately obtain and document referrals and pre-authorizations for patients. The role requires coordinating with physicians, insurance companies, and patients to ensure authorization for doctors, dates of service, and anticipated procedures.

The ideal candidate has 2+ years in a medical environment, strong communication, and the ability to manage multiple tasks in a fast-paced setting.