Prior Authorization & Insurance Verification Specialist

Vitas Healthcare Corporation; Town of Florida (NY); On-site; USD 52,000 - 68,000; Full time

Job summary

Vitas Healthcare Corporation is seeking a Prior Authorization Coordinator to ensure accurate insurance data, maintain authorizations, and support efficient revenue cycle operations. The role is based on-site at our Miramar, Florida corporate office with a hybrid schedule (Mon-Fri 8:30/9:00–5:00/5:30).

The coordinator will verify payor sources, obtain authorizations, assist departments, and manage payer information to ensure proper reimbursement and compliance.

Qualifications

• Two years of healthcare Revenue Cycle experience, preferably in registration/financial clearance.
• Understanding of medical terminology and clinical documentation.
• Knowledge of how insurance verification and prior authorization impact Revenue Cycle operations.
• Experience with commercial insurance carriers' guidelines for verification and reimbursement.
• Strong customer service skills when handling internal and external inquiries.
• Ability to prioritize and multitask in a dynamic work environment.
• Proficiency with PC-based office tools (Outlook, Excel) and general computer skills.

Responsibilities

• Prioritize and process incoming Insurance Verifications and Prior Authorization requests.
• Verify Medicaid, private insurance, and self-pay payor sources via phone or online systems.
• Obtain authorizations from private insurers and other payors as required.
• Maintain authorizations extensions for all patients when appropriate.
• Refer complex requests to the Prior Authorization Supervisor and clinical staff.
• Coordinate with agencies to assist with obtaining authorizations and re-authorizations.
• Assist other departments in collecting client and payor information for accurate reimbursement.
• Enter hospice benefit information into Registration Tool and patient accounting system.
• Respond to calls, emails, and inquiries regarding status of referrals and authorizations.
• Provide administrative support to the department as needed.
• Complete Payor Information Form (PIF) and Payor Change Request Forms (PCR).
• Update contracting personnel on payor information changes.
• Coordinate with members, providers, and departments to explain PA, referral, and verification requirements.
• Communicate efficiently to resolve issues in verification and authorization processes.
• Access Medicare's Common Working File (CWF) to verify eligibility when applicable.

Skills

Revenue Cycle

Medical Terminology

Insurance Verification

Customer Service

MS Office

Multitasking

Office Productivity Tools

Education

High School diploma or GED

Tools

Microsoft Outlook

Microsoft Excel

Registration Tool

Job description

Vitas Healthcare Corporation is seeking a Prior Authorization Coordinator to ensure accurate insurance data, maintain authorizations, and support efficient revenue cycle operations. The role is based on-site at our Miramar, Florida corporate office with a hybrid schedule (Mon-Fri 8:30/9:00–5:00/5:30).

The coordinator will verify payor sources, obtain authorizations, assist departments, and manage payer information to ensure proper reimbursement and compliance.