Referral Authorization Coordinator

KIDZ MEDICAL SERVICE.; West Palm Beach (FL); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Full benefits package

401(k) plan

In-office position

Job summary

KIDZ MEDICAL SERVICE in West Palm Beach, FL is seeking a dedicated Authorization Specialist to join our in-office team. You will verify insurance and provider details, prepare authorization requests, and coordinate with patients and providers to ensure timely approvals.

The role requires a high school diploma or GED, 0–3 months related experience, basic computer skills, and strong attention to detail. Bilingual ability is required.

Qualifications

• High school diploma or GED required; associate degree a plus.
• Experience in medical billing or insurance authorization is preferred.
• Knowledge of medical terminology and strong attention to detail are essential.

Responsibilities

• Verify insurance coverage and provider information for authorizations.
• Prepare and submit authorization requests with required documentation.
• Monitor authorizations and follow up on approvals or denials.
• Coordinate with physicians, insurance companies, and patients to resolve issues.

Skills

Medical terminology

Basic computer skills

Attention to detail

Bilingual

Education

High school diploma or GED

Associate degree a plus

Job description

Job Description

Job Description

We are looking for a energetic, hard-working, dependable, multi-tasking Medical Insurance Authorization specialists who are passionate about helping others and making a difference.

SUMMARY: The Authorization Specialist completes authorizations and referrals for our medical services. In addition to reviewing the medical history of potential patients, verifies information provided by referring physicians and verifies insurance coverage. Also monitors the schedule for add-on patients, ensuring there are no conflicts we have the prior authorization needed to move forward with appointment or procedure.

DUTIES AND RESPONSIBILITIES: __

• Verifies information provided by referring physicians and verifies insurance coverage.

  • Analyze patient records and insurance policies to determine if procedures, treatments, or medications require prior authorization
  • Ensure patients are eligible for services and that insurance benefits are accurate
  • Interacts with healthcare providers, insurance companies, and patients to obtain and provide information needed for authorization decisions
  • Notify providers of potential coverage options
  • Communicate with patients about the authorization process and any potential delays or financial implications.
  • May suggest formulary/cheaper alternatives for expensive drugs.
  • May investigate any serious drug interactions with the requested drug.

• Completes authorizations and referrals for our medical services, including appointments and procedures.

  • Input new patient information and update information in our system
  • Compile and submit detailed authorization requests to insurance companies, including all necessary documentation
  • Research and resolve any issues or discrepancies related to authorization requests
  • Monitor and follow up on authorization requests to ensure timely processing
  • Investigate insurance denials and resubmit requests or appeal when necessary.
  • Complete billing documentation

• Monitors the schedule for add-on patients, ensuring no conflicts, and we have required prior authorization to move forward with appointment or procedure.

• Remain informed about healthcare industry regulations, trends and insurance policies

• Assist with other clerical tasks as needed and perform other related duties as assigned by management.

QUALIFICATIONS:

• High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience. Associate degree a plus.
• Some experience in medical billing or insurance authorization (strongly preferred).
• Knowledge of medical terminology.
• Basic computer skills.Attention to detail.

JOB TYPE / WORK SCHEDULE:

• This is a full-time position, in-office position
• Standard office hours, Monday - Friday 8:00 AM - 4:30 PM
• Bilingual Required

Competitive pay and full benefits package, including 401(k), health, dental, vision, life, and disability insurance.