Authorization Specialist - HFMG Central Service Org_

*POSITION SUMMARY: *Responsible for verifying eligibility, obtaining insurance benefits, and ensuring precertification, authorization, and referral requirements are met prior to the delivery of outpatient, and ancillary services. This position determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care.*PRIMARY ACCOUNTABILITIES: ** Handles the verification of insurance benefits for customers  Notifies customers of deductibles and co-insurance requirements* Regularly calls insurance companies to follow up on status of the authorization* Explores other payment options with customer when needed* Applies detailed knowledge of ICD10 and CPT codes* Process referrals and submit medical records to insurance carriers to expedite prior authorization processes in accordance with Health First policy and procedures* Manage correspondence with insurance companies, physicians, specialists, and patients as required and ensures accurate and timely documentation of these contacts.* Handles incoming/outgoing emails, faxes and phone calls with patients, clinic staff, insurance providers.* Achieve individual productivity and quality metrics set by management* Ensures confidentiality of all health information as required by Florida Statutes and HIPAA guidelines ensuring compliance.* Handles the verification of insurance benefits for customers  Notifies customers of deductibles and co-insurance requirements* Regularly calls insurance companies to follow up on status of the authorization* Explores other payment options with customer when needed* Applies detailed knowledge of ICD10 and CPT codes* Process referrals and submit medical records to insurance carriers to expedite prior authorization processes in accordance with Health First policy and procedures* Manage correspondence with insurance companies, physicians, specialists, and patients as required and ensures accurate and timely documentation of these contacts.* Handles incoming/outgoing emails, faxes and phone calls with patients, clinic staff, insurance providers.* Achieve individual productivity and quality metrics set by management* Ensures confidentiality of all health information as required by Florida Statutes and HIPAA guidelines ensuring compliance.*MINIMUM QUALIFICATIONS REQUIRED:** *Education:*High School or GED* *Work Experience:*Two (2) years performing healthcare insurance authorizations OR Two (2) years as a clinical healthcare provider with background using CPT and ICD 10 codes* *Specific Knowledge/Skills/Abilities:*o Working knowledge of Microsoft Office – Outlook, Word, Excelo Intermediate keyboarding skillso Understanding of CPT codes and ICD 10 numberso Intermediate medical terminologyo Basic insurance knowledgeo Able to operate and stay organized when using multiple computer screens and website windows and function effectively in a call center environment**Job:** **Clinic Clerical Support***Organization:** **Health First Medical Group LLC***Title:** *Authorization Specialist - HFMG Central Service Org***Location:** *Florida - Brevard County-Melbourne***Requisition ID:** *073503*