Health First
Authorization Specialist - HFMG Central Service Org
Health First, Melbourne, Florida, United States, 32935
*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, Excel o Intermediate keyboarding skills o Understanding of CPT codes and ICD 10 numbers o Intermediate medical terminology o Basic insurance knowledge o 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
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, Excel o Intermediate keyboarding skills o Understanding of CPT codes and ICD 10 numbers o Intermediate medical terminology o Basic insurance knowledge o 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