Insurance Authorization Coordinator I – Casual

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

📋 Description

• Secure authorizations for services provided by hospitals and/or physicians.

• Utilize workqueues and various tools to initiate authorizations and referrals, follow up on requests, monitor appointment modifications, and document any changes.

• Complete authorizations and referrals in alignment with departmental objectives and standards.

• Verify insurance eligibility, authorization prerequisites, plan benefits, and the financial responsibilities of patients.

• Process appointment modifications, scheduling changes, date alterations, and significant service changes that require immediate attention.

• Review clinical documentation and submit essential information to insurance payers.

• Keep accurate records of authorization requests, approvals, denials, correspondence, patient data, and insurance information.

• Relay authorization status to patients, families, healthcare providers, and relevant stakeholders.

• Collaborate with healthcare providers, physicians, clinical personnel, the Central Business Office, Financial Services, Transport, Patient Cost Estimation, Managed Care, Utilization Review, and other departments.

• Recognize authorization challenges, address denials, appeal outcomes, and explore alternative solutions.

• Engage in daily departmental huddles and report issues related to payers, workflow obstacles, and risks associated with non-reimbursable or canceled services.

• Maintain professional relationships with contacts in specialty departments while providing excellent customer service.

• Adhere to relevant laws, regulations, privacy standards, and organizational policies.

⛳️ Requirements

• A minimum of one year of specialized training beyond high school.

• At least 6 months of experience in insurance authorization is required.

• Capability to request and secure preauthorization for assigned specialties and manage other workflows, including items in workqueues.

• Proficient in submitting required documentation and following up to guarantee timely approvals.

• Understanding of insurance policies, guidelines, authorization, and reimbursement processes.

• Ability to verify insurance coverage, eligibility, demographics, benefits, and patient financial responsibility.

• Skilled in identifying prior authorization and predetermination requirements.

• Proficient in reviewing clinical documentation to extract necessary information for payers.

• Strong documentation and record-keeping abilities.

• Effective communication skills with patients, families, healthcare professionals, and internal departments.

• Ability to identify challenges, address denials, appeal decisions, and seek alternative solutions.

• Well-organized and capable of working effectively in a virtual team environment; adept at problem-solving and seeking assistance when necessary.

• Exceptional, empathetic, and knowledgeable customer service skills.

• Ability to comply with laws, regulations, privacy guidelines, and organizational policies.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with employer match.

• Generous paid time off and holiday schedule.

• Professional development opportunities and training.

• Supportive work environment and team-oriented culture.