Prior Authorizations Representative

Suncoast Orthopaedic Surgery & Sports Medicine, P.A.; Venice (FL); On-site; USD 35,000 - 45,000; Full time

Benefits offered by this job

Comprehensive health, dental, and vision insurance

Retirement plan with employer contributions

Paid time off and holidays

Supportive and collaborative work environment

Job summary

A healthcare organization in Florida is seeking a dedicated Prior Authorizations Representative to process authorization requests and ensure timely document submission. Essential responsibilities include reviewing requests for medical services, coordinating with patients and insurance companies, and maintaining accurate records. Ideal candidates will have a high school diploma with experience in healthcare or customer service, strong attention to detail, and excellent communication skills. Join our supportive team and enjoy comprehensive benefits including health insurance and retirement plans.

Qualifications

• Experience in a healthcare or customer service setting preferred.
• Ability to work accurately under time constraints.
• Knowledge of medical terminology and insurance policies.

Responsibilities

• Review and process prior authorization requests.
• Collect and submit documentation to insurance companies.
• Communicate with healthcare providers and patients.
• Maintain records of prior authorization requests.
• Identify urgent or complex cases for resolution.

Skills

Attention to detail

Communication skills

Customer service

Teamwork

Education

High school diploma or equivalent

Tools

Electronic medical record systems

Office software

Job description

Prior Authorizations Representative

Job Description

We are seeking a dedicated and detail-oriented Prior Authorizations Representative to join our team. In this role, you will be responsible for processing prior authorization requests, ensuring timely and accurate submission of documentation, and serving as a liaison between patients, healthcare providers, and insurance companies.

Responsibilities:

• Review and process prior authorization requests for various medical services, procedures, and medications
• Collect and submit all necessary documentation and supporting information to insurance companies
• Communicate with healthcare providers, patients, and insurance companies to obtain additional information or resolve any issues
• Maintain accurate and up-to-date records of all prior authorization requests and their status
• Identify and elevate urgent or complex cases to ensure timely resolution
• Collaborate with the medical and billing teams to ensure seamless coordination of patient care
• Stay informed of changes in insurance policies and prior authorization requirements
• Provide excellent customer service and respond to inquiries in a timely and professional manner

Qualifications:

• High school diploma or equivalent, with some experience in a healthcare or customer service setting preferred
• Strong attention to detail and ability to work accurately under time constraints
• Excellent communication and interpersonal skills, both written and verbal
• Proficiency in using electronic medical record systems and office software
• Knowledge of medical terminology, insurance policies, and prior authorization processes
• Ability to work independently and as part of a team
• Passion for providing exceptional patient care and customer service

Benefits:

• Comprehensive health, dental, and vision insurance
• Retirement plan with employer contributions
• Paid time off and holidays
• Supportive and collaborative work environment

If you are interested in this opportunity and meet the qualifications, please submit your resume and cover letter to [insert email address or application link].