Prior Authorization Specialist - Streamline Care & Compliance

Tallahassee Memorial HealthCare; Tallahassee (FL); On-site; USD 45,000 - 60,000; Full time

Job summary

Tallahassee Memorial HealthCare (TMH) is a private, nonprofit community-based healthcare system serving a 22-county region in North Florida and South Georgia. We offer a 772-bed acute care hospital with Level II Trauma Center, Primary Stroke Center, NICU, PICU, and top cancer, heart, vascular, orthopedic and surgery programs.

The role focuses on managing the prior authorization process, verifying coverage, maintaining documentation, and collaborating with clinicians to ensure timely patient

Qualifications

• High school diploma or equivalent required.
• Two years of relevant, job-related work experience.
• Preferred: vocational certificate or associate degree in healthcare, education, information science, or related field.

Responsibilities

• Manage the prior authorization process for medical procedures, treatments, and medications to ensure prompt approvals and smooth patient care.
• Manage prior authorizations.
• Maintain documents and records.
• Verify insurance coverage.
• Collaborate with healthcare providers, physicians, and clinical staff.
• Audit documents to ensure regulatory compliance.
• Demonstrate I CARE values (integrity, compassion, accountability, respect, excellence).
• Enhance a safe environment for colleagues, visitors, and patients.
• Perform miscellaneous duties.

Skills

Prior authorizations

Insurance verification

Multitasking

Attention to detail

Communication

Education

High school diploma or equivalent

Vocational certificate or associate degree (preferred)

Tools

Allscripts PM

Allscripts EHR

Job description

Tallahassee Memorial HealthCare (TMH) is a private, nonprofit community-based healthcare system serving a 22-county region in North Florida and South Georgia. We offer a 772-bed acute care hospital with Level II Trauma Center, Primary Stroke Center, NICU, PICU, and top cancer, heart, vascular, orthopedic and surgery programs.

The role focuses on managing the prior authorization process, verifying coverage, maintaining documentation, and collaborating with clinicians to ensure timely patient