Prior Authorization Specialist for Patient Care

Tallahassee Memorial HealthCare; Tallahassee (FL); On-site; USD 42,000 - 65,000; Full time

Job summary

Tallahassee Memorial HealthCare in Tallahassee seeks a detail-oriented Prior Authorization Specialist to manage the prior authorization process for procedures and medications, ensuring prompt approvals and smooth patient care.

You will verify insurance coverage, maintain records, collaborate with clinicians, audit documents for regulatory compliance, uphold I CARE values, and support a safe, diverse environment.

Qualifications

• High school diploma or equivalent is required.
• Preferred: Vocational certificate or associate degree in a healthcare, education, information science, or related field.
• Two years of relevant work experience.
• Preferred: Two years of experience with Allscripts PM and EHR; clinical background or billing/collections.
• Knowledge of Allscripts.
• Ability to multi-task effectively.
• Very meticulous.

Responsibilities

• Manages the prior authorization process for medical procedures, treatments, and medications; uses a proactive approach to ensure prompt approvals and facilitate smooth patient care.
• Manages prior authorisations.
• Maintains documents and records.
• Verifies insurance coverage.
• Collaborates with healthcare providers, physicians, and clinical staff members.
• Audits documents to ensure regulatory compliance.
• Displays an understanding of diversity.
• Demonstrates integrity, compassion, accountability, respect, and excellence (I CARE values).
• Enhances and contributes to a safe environment for all colleagues, visitors, and patients.
• Performs miscellaneous duties.

Skills

Very meticulous

Multi-tasking

Education

High school diploma or equivalent

Vocational certificate or associate degree in healthcare, education, information science, or related field

Tools

Allscripts Practice Management

Allscripts EHR

Job description

Tallahassee Memorial HealthCare in Tallahassee seeks a detail-oriented Prior Authorization Specialist to manage the prior authorization process for procedures and medications, ensuring prompt approvals and smooth patient care.

You will verify insurance coverage, maintain records, collaborate with clinicians, audit documents for regulatory compliance, uphold I CARE values, and support a safe, diverse environment.