Prior Authorization Specialist — Hybrid (Fridays From Home)

VITAS Healthcare; United States; Hybride; USD 38 000 - 52 000; Plein temps

Avantages offerts par ce poste

Health insurance

401(k) plan

Paid Time Off

Life insurance

Résumé du poste

VITAS Healthcare is seeking a Prior Authorization Coordinator in Miramar, FL. The role supports efficient insurance verifications, authorizations, and revenue cycle processes, ensuring accurate patient data and timely approvals.

Typical schedule is weekdays, with the option to work from home on Fridays after 90 days. This hybrid on-site role involves collaboration with care teams and administrative staff to meet payor requirements and improve reimbursement outcomes.

Qualifications

• Two years of related healthcare Revenue Cycle experience.
• Understanding of medical terminology and clinical documentation.
• Knowledge of insurance verification and authorization impact on Revenue Cycle.
• Customer service skills with internal and external customers.
• Ability to multitask in a dynamic work environment.
• Proficient in PC-based office tools.

Responsabilités

• Ensure quality and accuracy of patient insurance information and that listed certification periods, billing addresses, policy numbers, authorization numbers are entered correctly.
• Prioritize and process incoming Insurance Verifications and Prior Authorization requests.
• Verify Medicaid, private insurance, and self-pay payor sources via telephone or online systems.
• Obtain authorization from private insurance and other payors via telephone, fax, or online systems while maintaining confidentiality.
• Maintain authorizations extension for all patients as appropriate.
• Refer authorization requests requiring clinical judgment to Prior Authorization Supervisor.
• Enter all hospice benefit information into Registration Tool and patient accounting system.
• Respond to calls, emails and other inquiries regarding status of referrals and/or authorization information.
• Provide other administrative support to the department as needed.
• Complete Payor Information Form and Payor Change Request Forms as needed.
• Update Contracting Coordinator of payor information changes.
• Coordinate with members, providers and key departments to promote understanding of Prior Authorization, Referral, and Insurance Verification requirements.
• Communicate efficiently to resolve issues pertaining to the verification and authorization processes.
• Access Medicare's Common Working File (CWF) to verify eligibility if applicable.

Formation

High School diploma or GED

Outils

Microsoft Outlook

Microsoft Excel

Description du poste

VITAS Healthcare is seeking a Prior Authorization Coordinator in Miramar, FL. The role supports efficient insurance verifications, authorizations, and revenue cycle processes, ensuring accurate patient data and timely approvals.

Typical schedule is weekdays, with the option to work from home on Fridays after 90 days. This hybrid on-site role involves collaboration with care teams and administrative staff to meet payor requirements and improve reimbursement outcomes.