Prior Authorization Specialist - Streamline Patient Care

Nflsurgeons; Jacksonville (FL); On-site; USD 42,000 - 54,000; Full time

Job summary

North Florida Surgeons, Colon and Rectal Associates is seeking a Precertification/Authorization Specialist to help patients access care by coordinating insurance prior to authorization and verifying coverage. You will review medical records, apply policy knowledge, and communicate clearly with providers and insurers.

Your work will ensure accurate, timely authorization support, navigate coverage requirements, and support care teams in coordinating treatment steps with payers while maintaining

Qualifications

• Medical office experience
• Dental office experience is relevant
• Knowledge of health insurance, verification, managed care, and policy requirements

Responsibilities

• Verify insurance eligibility and benefits and identify authorization requirements for planned services.
• Review medical records and clinical documentation; use CPT/ICD coding to support requests.
• Submit and track prior authorization requests with managed care plans; follow up on missing information or decisions.
• Update EMR/EHR systems, maintain records, and document communications accurately.
• Protect patient confidentiality by following HIPAA policies and provide responsive customer service.

Skills

Health insurance knowledge

HIPAA compliance

EMR/EHR management

CPT/ICD coding

Microsoft Office

Tools

Microsoft Office

Job description

North Florida Surgeons, Colon and Rectal Associates is seeking a Precertification/Authorization Specialist to help patients access care by coordinating insurance prior to authorization and verifying coverage. You will review medical records, apply policy knowledge, and communicate clearly with providers and insurers.

Your work will ensure accurate, timely authorization support, navigate coverage requirements, and support care teams in coordinating treatment steps with payers while maintaining