Top 41 Prior authorization specialist Jobs in Hialeah, Fl

Medical Authorizations Specialist (Infusion Centers) - Pembroke Pines FL
Coastal Medical Group —Pembroke Pines, FL
- From $22 an hour
- Full-time
- Background check
- Spanish
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
1d
Medication Access Specialist - Pharmacy Technician - FT - Days - Memorial Home Infusion
Memorial Healthcare System —Miramar, FL
- Full-time
- Customer service
- Data analysis skills
- Mid-level
Medication Access Specialist - Pharmacy Technician - FT - Days - MSP
Memorial Healthcare System —Miramar, FL
- Full-time
- Customer service
- Data analysis skills
- Mid-level
Pharmacy Medication Assistance Liaison, Specialty Pharmacy, Per Diem,Varies
Baptist Health South Florida —Miami Lakes, FL
- Per diem
- Customer service
- 5 years
- Research
- Wellness program
- Health insurance
Specialist, Benefits Eligibility and Authorizations
Cardinal Health —Doral, FL
- $20.02 - $25.78 an hour
- Monday to Friday
- Research
- Mid-level
- Office
- Paid parental leave
- Health savings account
14d
Prior Authorization Certified Pharmacy Technician
Shields Health Solutions —Miami, FL
- $19.45 - $22.21 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- Research
Quick Apply
13d
Authorization Specialist - Home Health - Broward, FL
Senior Care Solutions —Hallandale Beach, FL
- Full-time
- Hybrid work
- Mid-level
- Office
- Home Health
Quick Apply
Verification Specialist Outpt. Wound Care FT 8a-430p-BHMC
Broward Health —Fort Lauderdale, FL
- Full-time
- Hospital
- Outpatient experience
- High school diploma or GED
Medical Office Specialist
HCA FL Weight Mgmt & Metabolic Wellness —Miami, FL
- Full-time
- Surgery
- Mid-level
- Cardiology
- Employee stock purchase plan
- Disability insurance
Quick Apply
Remote ABA Therapy Medical Billing Specialist
House of Hearts ABA —Hollywood, FL
- $20 - $28 an hour
- Part-time
- Remote
- Bachelor's degree
- Children
- Organizational skills
Quick Apply
10d
Patient Transfer Center Associate, Full Time, Nights (9pm - 730am)
Jackson Health —Miami, FL
- Full-time
- Hospital
- Inpatient
- Residential
Quick Apply
Prior Authorization Specialist - Toxin Injections
First Choice Neurology —Medley, FL
- $20 - $22 an hour
- Full-time
- Medical office experience
- HIPAA
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Patient Access Specialist (On-Site) - UHealth SoLé Mia
University of Miami —North Miami, FL
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Patient Access Specialist – UHealth SoLé Mia
University of Miami —North Miami, FL
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Referral Authorization Coordinator
Vanguard Plastic Surgery —Fort Lauderdale, FL
- Full-time
- Surgery
- Customer service
- Medical office experience
Quick Apply
7d
Patient Access Specialist (On-Site)
University of Miami —Miami, FL
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Coordinator, Referrals
Cano Health LLC —Aventura, FL
- Extended hours
- Spanish
- Microsoft Excel
- Oracle
Quick Apply
12d
Patient Scheduler 2, Radiology, Full Time
University of Miami —Miami, FL
- Full-time
- Microsoft Access
- Microsoft Outlook
- Mid-level
- Health insurance
- Dental insurance
Care Coordinator
Chen Medical Associates —Hallandale Beach, FL
- $17.00 - $24.26 an hour
- Entry level
- Opportunities for advancement
Patient Access Representative Specialist (Onsite) (H))
University of Miami —Coral Gables, FL
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance

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prior authorization specialist jobs near hialeah, fl

Medical Authorizations Specialist (Infusion Centers) - Pembroke Pines FL

Coastal Medical Group
Pembroke Pines, FL

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Job Details

Full-time
From $22 an hour
1 day ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Overseeing health insurance pre-certification
Medical insurance coverage verification

Full Job Description

PRIOR AUTHORIZATION SPECIALIST - Infusion Centers

Pembroke Pines, FL

Coastal Medical Group is seeking an experienced Prior Authorization Specialist to join our growing team. Under the direction of our Associate Medical Director, you will be responsible for securing insurance authorizations for infusions of biologics and other specialty medications for our infusion centers, Coastal Infusion.

You will work closely with patients, our healthcare providers and staff, insurance companies, and our pharmacy team to ensure timely approval of treatment plans and medication access. The ideal candidate will have strong communication skills, a deep understanding of insurance processes, and a passion for helping patients access critical therapies.

In addition, preference will be given to candidates who have experience securing authorizations for

rheumatology
gastroenterology
neurology
medical infusion (including oncology)
or specialty pharmacy.

This is a full-time position, Monday through Friday.

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KEY RESPONSIBILITIES

Insurance Verification & Authorization:

Submit Prior-Auth Requests: Prepare and submit prior authorization requests through payer portals, electronic prior authorization platforms, fax, and phone to all major payers (insurance companies) in south Florida, ensuring that required documentation, including letters of medical necessity and clinical information, is accurately submitted.
Collect Documentation: Download most required information from the electronic medical record (EMR) systems belonging to Coastal Medical Group companies, including eClinical Works and eMedical. When necessasry work with in-house medical providers to gather additional required documentation.
Monitor and Follow-Up: Monitor authorization status and follow up with insurance companies to ensure timely processing.
Appeal Denials: Identify authorization denials and coordinate appeals, reconsiderations, and peer-to-peer review requests when appropriate.
Maintain EMR Data: Maintain detailed records of authorization activity within our infusion center EMR, WeInfuse.

Patient & Provider Liaison:

Serve as the main Point of Contact: Interact with patients and providers regarding insurance authorizations and coverage questions.
Educate Patients: Explain insurance processes, including prior authorization requirements, medication coverage, and financial assistance programs to patients.

Compliance and Quality:

Ensure HIPAA Compliance
Ensure Accuracy and completeness of documentation.
Stay Current: Ensure understanding of payer policies, formularies, and authorization requirements.

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MINIMUM REQUIREMENTS

We regret that we cannot consider applications that do not show evidence of all three of these requirements:

Education: Candidates must have completed at least a two-year college degree in healthcare or a related field. Two years' additional work experience may be substituted.
Experience: Minimum of 2 years of experience in insurance authorizations at a specialty pharmacy or a medical specialist's office (for example rheumatology, gastroenterology, neurology).
Skills & Knowledge: A comprehensive understanding of insurance verification of specialty medications such as those for IV infusion or chemotherapy.

Preference will be given to candidates with the following additional qualifications:

Rheumatology or Related Experience: Experience with rheumatology, gastroenterology, neurology, medical infusion (including oncology) or specialty pharmacy prior authorizations is strongly preferred
Bilingual: This means that you can communicate fluently and with confidence in both English and Spanish.

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WHAT YOU GET

Compensation: Starting at $22.00/hour, with higher compensation available based on experience and qualifications.
Benefits: Medical, dental, vision
Generous paid time off
401(k) plan
Standard Hours: Work regular business hours, Monday-Thursday, and until early afternoon on Fridays.
Exceptional Team: The Coastal Medical team has been recognized as among the best in the business; you'll work with highly-motivated and compassionate team members with a passion for patient care.

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ABOUT US

Coastal Medical Group is a fast-growing medical provider, including South Florida Rheumatology (south Florida's first rheumatology office), the Rheumatology Center Inc, Coastal Infusion, and Water Lilly Pharmacy, and a non-profit community health center in south Florida.

We are expanding and interested in continuing to find driven team members to contribute to our mission of delivering exceptional patient care.

Coastal Medical Group is committed to providing an environment of mutual respect. We offer employment without regard to race, color, religion, sex, pregnancy, national origin, age, disability, marital status, sexual orientation, gender identity, gender expression, military and veteran status, and any other characteristic protected by law.

We believe that diversity is critical to our success as a company. We are an inclusive workplace where employees excel based on personal merit, qualifications, experience, ability, and job performance.

Minority candidates are encouraged to apply.

JOB SEEKERS ONLY

COASTAL MEDICAL GROUP HAS A STRICT POLICY PROHIBITING THE PAYMENT OF FEES TO HEADHUNTERS OR EMPLOYMENT AGENCIES. ANY REFERRALS SUBMITTED WILL BE CONSIDERED FREE REFERRALS. NO FEES WILL BE PAID.

Job Type: Full-time

Pay: From $22.00 per hour

Application Question(s):

We know it's on your resume, but if you don't mind, please summarize the number of years' experience you have in a prior authorization role? Is this at a specialist office (rheum, gastro, neuro, pharmacy) or somewhere else?

Work Location: In person

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Refine Your Search

prior authorization specialist jobs in hialeah, fl

Medical Authorizations Specialist (Infusion Centers) - Pembroke Pines FL

Medication Access Specialist - Pharmacy Technician - FT - Days - Memorial Home Infusion

Medication Access Specialist - Pharmacy Technician - FT - Days - MSP

Pharmacy Medication Assistance Liaison, Specialty Pharmacy, Per Diem,Varies

Specialist, Benefits Eligibility and Authorizations

Prior Authorization Certified Pharmacy Technician

Authorization Specialist - Home Health - Broward, FL

Verification Specialist Outpt. Wound Care FT 8a-430p-BHMC

Medical Office Specialist

Remote ABA Therapy Medical Billing Specialist

Patient Transfer Center Associate, Full Time, Nights (9pm - 730am)

Prior Authorization Specialist - Toxin Injections

Patient Access Specialist (On-Site) - UHealth SoLé Mia

Patient Access Specialist – UHealth SoLé Mia

Referral Authorization Coordinator

Patient Access Specialist (On-Site)

Coordinator, Referrals

Patient Scheduler 2, Radiology, Full Time

Care Coordinator

Patient Access Representative Specialist (Onsite) (H))

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