Insurance Authorization Coordinator

This is a fully remote position, open to applicants in Florida.

📋 Description

• Secure preauthorization for designated specialties and manage various workflow tasks.

• Submit necessary documentation and follow up to guarantee prompt authorization approvals.

• Process authorization and notification requests in line with departmental policies and payer requirements.

• Verify insurance coverage, eligibility, demographics, benefits, and patient financial responsibilities.

• Identify prior authorization and predetermination criteria for medical procedures and treatments.

• Stay informed about insurance policies, guidelines, procedures, and medical coverage standards.

• Manage appointment additions, schedule modifications, date alterations, and significant service changes.

• Follow administrative review protocols for services that lack authorization beyond standard timelines.

• Communicate updates regarding authorizations and address inquiries from patients, families, and healthcare professionals.

• Review clinical documentation for necessary information required in payer submissions.

• Maintain precise records of requests, approvals, denials, correspondence, patient details, insurance information, and authorization activities.

• Collaborate with healthcare providers, physicians, clinical staff, Central Business Office, Financial Services, Transport, Patient Cost Estimation, Managed Care, Utilization Review, Authorization Departments, and other relevant teams.

• Address authorization obstacles, denials, and appeals while identifying alternative solutions.

• Participate in daily departmental meetings and report payer concerns, workflow challenges, and risks of non-reimbursable or canceled services.

• Comply with all relevant laws, regulations, privacy standards, and organizational policies.

• Perform additional responsibilities as assigned.

⛳️ Requirements

• High School Diploma is mandatory.

• Six months to two years of experience in authorization is essential.

• Familiarity with insurance plans and third-party payer requirements is required.

• Understanding of CPT and ICD-10 codes alongside basic medical terminology is needed.

• Knowledge of role-specific Epic Applications is necessary.

• Proficiency in Microsoft Word, Excel, and Outlook is required.

• Capability to work efficiently in a virtual team environment.

• Ability to identify and resolve authorization challenges, denials, and appeals is necessary.

• Must maintain accurate authorization and insurance records.

• Compliance with laws, regulations, privacy standards, and organizational policies is essential.

🏝️ Benefits

• Competitive base salary within the top quartile of the market.

• Annual incentive compensation.

• Extensive health, life, dental, and vision benefits.

• 403B plan with employer matching.

• Allowance for licensure, CME, and dues.

• Not-for-profit status, eligible for Public Service Loan Forgiveness.

• No state income tax for residents working in Florida.

• Moderate tax structure for employees based in Delaware.