Referral & Authorization Specialist

Florida-Orthopaedic-Institute; Rio Vista (FL); On-site; USD 36,000 - 52,000; Full time

Job summary

Florida-Orthopaedic-Institute in Saint Petersburg, FL is seeking an Authorization Representative to obtain referrals and authorizations for patients. You will coordinate with physicians’ offices, insurers and patients to ensure coverage and timely service.

Key duties include documenting authorizations in the system, advising patients of potential issues, and working with Billing/Collections and Benefit Verification to resolve denials and verify benefits.

Qualifications

• High school diploma.
• 2+ years of experience in a medical environment.
• Excellent customer service and communication skills.
• Able to multi-task and handle high call volumes.

Responsibilities

• Coordinate with appropriate primary care physicians and/or insurance companies to obtain referrals for office visits prior to the patient’s scheduled appointment.
• Ensure all authorizations are properly documented in the system.
• Advise patients of any potential problems concerning obtaining authorization prior to the scheduled appointment.
• Coordinate with the Billing/Collections department to research and obtain authorizations on previously denied claims.
• Coordinate with the Benefit Verification Rep to confirm benefits when problems occur.
• Utilize insurance websites (Availity, Humana Military (Tricare),United Healthcare, etc.) to obtain referrals/authorizations
• All other duties as assigned

Skills

Customer service

Communication skills

Multi-tasking

Handling high call volumes

Education

High school diploma

Job description

Florida-Orthopaedic-Institute in Saint Petersburg, FL is seeking an Authorization Representative to obtain referrals and authorizations for patients. You will coordinate with physicians’ offices, insurers and patients to ensure coverage and timely service.

Key duties include documenting authorizations in the system, advising patients of potential issues, and working with Billing/Collections and Benefit Verification to resolve denials and verify benefits.