Remote Authorization Specialist – Health Coverage

Baycare; Winter Haven (FL); Remote; USD 42,000 - 56,000; Full time

Job summary

BayCare seeks a Central Authorization Specialist to verify insurance information and obtain authorizations for inpatient, observation, and outpatient services. The role requires Florida residency and includes remote work after onsite training.

Responsibilities include assisting clinical teams and denials management, using payer websites, and documenting in Soarian or GE systems. 1 year in insurance verification and health website experience is preferred.

Qualifications

• Required: High School or Equivalent; Preferred: Associates in Business or Health Services.
• 1 year of Insurance Verification and Authorization Retrieval or Referrals.
• 1 year of Health Insurance Website experience.
• Preferred - 1 year of Healthcare Business Office and/or Managed Care experience.

Responsibilities

• Verify health insurance information and obtain authorizations, pre-certifications, and/or referrals for inpatient, observation and outpatient elective services.
• Assist patients, clinical teams, physicians and staff, the BayCare central business office, and denials management with information and process details for timely turnaround for authorizations.
• Utilize electronic scheduling/registration/financial systems, payer's websites, and recorded calls to validate health coverage and benefits in processing approval for medical services.
• Maintain proper documentation in Soarian or GE systems.
• Work closely with Managed Care and understand health insurances rule sets, manuals, and contract language.

Education

High School or Equivalent

Associates - Business or Health Services

Tools

Soarian

GE systems

Job description

BayCare seeks a Central Authorization Specialist to verify insurance information and obtain authorizations for inpatient, observation, and outpatient services. The role requires Florida residency and includes remote work after onsite training.

Responsibilities include assisting clinical teams and denials management, using payer websites, and documenting in Soarian or GE systems. 1 year in insurance verification and health website experience is preferred.