Prior Authorization Specialist – Healthcare Billing

Florida Digestive Health Specialists, LLP; Tampa (FL); On-site; USD 42,000 - 52,000; Full time

Job summary

Florida Digestive Health Specialists, LLP is seeking an Authorization Specialist to ensure timely and accurate prior authorizations for procedures, treatments, and services. You will coordinate with providers, insurance companies, our Central Billing Office, and patients to verify coverage and secure approvals, improving reimbursement and patient satisfaction.

The role requires strong communication, attention to detail, and knowledge of healthcare insurance processes, with responsibilities

Qualifications

• High School Diploma or equivalent.
• Minimum of 2 years’ experience in medical billing, insurance verification, or authorization processes.
• Knowledge of healthcare insurance plans, HIPAA regulations, and medical terminology.
• Proficiency in EMR software and basic computer applications (e.g. MS 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 EMR system.
• Monitor authorization status and follow up with insurers to secure timely approvals.
• Inform patients of authorization status, coverage details, and potential out-of-pocket expenses.
• Collaborate with physicians, nurses, and other providers to gather documentation for requests.
• Work with the Central Billing Office (CBO) to ensure accurate submission of claims.
• Assist billing with preparation of billing data and medical claim submission.
• Address and resolve issues related to insurance authorizations.
• Appeal denied authorizations with appropriate documentation.
• Maintain knowledge of insurance policies, procedures, and regulatory requirements.
• Ensure HIPAA compliance and patient confidentiality.

Skills

Communication

Interpersonal skills

Organizational skills

Attention to detail

Problem-solving

Education

High School Diploma or equivalent

Tools

EMR software

Microsoft Office

Job description

Florida Digestive Health Specialists, LLP is seeking an Authorization Specialist to ensure timely and accurate prior authorizations for procedures, treatments, and services. You will coordinate with providers, insurance companies, our Central Billing Office, and patients to verify coverage and secure approvals, improving reimbursement and patient satisfaction.

The role requires strong communication, attention to detail, and knowledge of healthcare insurance processes, with responsibilities