Top 43 Authorization representative Jobs in Ocala, Fl

Insurance Reviewer Clinical
Florida Cancer Affiliates —Ocala, FL
- HIPAA
- Research
- Mid-level
- Wellness program
- Disability insurance
3d
Financial Advisor | Business Owners, Sales Leaders & Career Changers Welcome
Northwestern Mutual —Ocala, FL
- $65,000 - $200,000 a year
- Full-time
- Hybrid work
- Background check
- 3 years
- Criminal background check
- Health savings account
- Health insurance
Quick Apply
Office Assistant - Bilingual Chinese/English
New Southern Food Distribution Inc —Ocala, FL
- $14 - $15 an hour
- Full-time
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
9d
Staff Assistant
The Orthopaedic Institute —Ocala, FL
- Full-time
- Writing skills
- High school diploma or GED
- Clinic
Quick Apply
Guest Services Coordinator
Camp Margaritaville Resort Orange Lake —Citra, FL
- Part-time
- Ability to walk for extended periods
- Computer literacy
- Office
- Wellness program
- Commuter assistance
Quick Apply
RN Outpatient Oncology/ Infusion
Florida Cancer Affiliates —Ocala, FL
- Nursing
- OSHA
- RN License
- Wellness program
- Disability insurance
2d
Business Development Representative - Legal
Complete Care Centers LLC —Ocala, FL
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Administrative Operations Manager
HEART OF THE VILLAGES PLC —Lady Lake, FL
- Full-time
- OSHA
- HIPAA
- Clinic
Quick Apply
Registered Nurse - Inpatient - Part Time
SMA Healthcare Inc —Ocala, FL
- Part-time
- Background check
- CPR Certification
- Clean driving record
- Disability insurance
- Health insurance
Registered Nurse - Inpatient - Relief On Call
SMA Healthcare Inc —Ocala, FL
- Day shift
- Background check
- CPR Certification
- Clean driving record
- 403(b)
Retail Assistant
Camp Margaritaville Resort Orange Lake —Citra, FL
- Part-time
- Ability to walk for extended periods
- Computer literacy
- Merchandising
- Wellness program
- Commuter assistance
Quick Apply
Food and Beverage Assistant
Camp Margaritaville Resort Orange Lake —Citra, FL
- Part-time
- Customer service
- Ability to walk for extended periods
- Computer literacy
- Wellness program
- Commuter assistance
Quick Apply
Waterslide Attendant
Camp Margaritaville Resort Orange Lake —Citra, FL
- Part-time
- Customer service
- Ability to walk for extended periods
- Ability to lift 50 pounds
- Wellness program
- Commuter assistance
Quick Apply
Sleep Expert - Sales
Mattress Firm, Inc —Lady Lake, FL
- $60,000 - $72,000 a year
- Full-time
- Ability to lift 50 pounds
- US work authorization
- Leadership
- Health insurance
- Dental insurance
Ranger
Camp Margaritaville Resort Orange Lake —Citra, FL
- Part-time
- Sales
- Customer service
- Ability to walk for extended periods
- Wellness program
- Commuter assistance
Quick Apply
ASSISTANT MANAGER - FINANCIAL SERVICES
Village Center Community Development District —The Villages, FL
- $67,992.94 a year
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Restaurant Host
Camp Margaritaville Resort Orange Lake —Citra, FL
- Part-time
- Ability to walk for extended periods
- US work authorization
- Ability to sit for extended periods
- Wellness program
- Commuter assistance
Quick Apply
Field Manager
Just Floors, LLC —Ocala, FL
- Full-time
- Management
- Construction site
- 5 years
- Paid holidays
- Health insurance
Quick Apply
11d
Case Manager - FIS
SMA Healthcare Inc —Ocala, FL
- Full-time
- Background check
- Nursing
- Clean driving record
- Paid holidays
- Disability insurance
Restaurant Server
Camp Margaritaville Resort Orange Lake —Citra, FL
- Part-time
- Ability to walk for extended periods
- US work authorization
- Ability to sit for extended periods
- Wellness program
- Commuter assistance
Quick Apply

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Insurance Reviewer Clinical

Florida Cancer Affiliates -
Ocala, FL

Apply Now

Job Details

3 days ago

Benefits

Wellness program
Disability insurance
Health insurance
Dental insurance
401(k)
Tuition reimbursement
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Life insurance

Qualifications

Medical insurance coverage verification
High school diploma or GED
Pre-authorization review for utilization management

Full Job Description

Overview:

Why work for us?
We offer our employees a competitive benefits package that includes Medical, Dental, Vision, Life Insurance, Short-term and Long-term disability coverage, a generous PTO program, a 401k plan that comes with a company match, a Wellness program that rewards you practicing a healthy lifestyle, and lots of other great perks such as Tuition Reimbursement, an Employee Assistance program and discounts on some of your favorite retailers.

SCOPE: Under general supervision, reviews chemotherapy regimens in accordance to reimbursement guidelines. Obtains necessary pre-certifications and exceptions to ensure no delay in reimbursement of treatments. Researches denied services and alternative resources to pay for treatment. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.

Responsibilities:

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence.
Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans. Provides prompt feedback to physicians and management regarding pathway documentation issues, and payer issues with non-covered chemotherapy drugs.
Updates coding/payer guidelines for clinical staff. Tracks pathways and performs various other business office functions on an as needed basis
Obtains insurance authorization and pre-certification specifically for chemotherapy services. Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
Researches additional or alternative resources for non-covered chemotherapy services to prevent payment denials. Provides a contact list for patients community resources including special programs, drugs and pharmaceutical supplies and financial resources.
Maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization. Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient's records.
Other duties as requested or assigned.

Qualifications:

MINIMUM QUALIFICATIONS: High school degree or equivalent. Associates degree in Healthcare, LPN state license and registration preferred. Minimum three (3) years medical insurance verification and authorization required.

COMPETENCIES: -Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded as an expert in the technical/functional area; accesses and uses other expert resources when appropriate. -Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility. -Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty. -Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them. -Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.

WORK ENVIRONMENT: The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.

Apply Now

Refine Your Search

authorization representative jobs in ocala, fl

Insurance Reviewer Clinical

Financial Advisor | Business Owners, Sales Leaders & Career Changers Welcome

Office Assistant - Bilingual Chinese/English

Staff Assistant

Guest Services Coordinator

RN Outpatient Oncology/ Infusion

Business Development Representative - Legal

Administrative Operations Manager

Registered Nurse - Inpatient - Part Time

Registered Nurse - Inpatient - Relief On Call

Retail Assistant

Food and Beverage Assistant

Waterslide Attendant

Sleep Expert - Sales

Ranger

ASSISTANT MANAGER - FINANCIAL SERVICES

Restaurant Host

Field Manager

Case Manager - FIS

Restaurant Server

I want to receive the latest job alert for authorization representative in ocala, fl

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