Top 5 Prior authorization specialist Jobs in Pensacola, Fl

Intake Specialist
Peoples Home Health, LLC —Pensacola, FL
- Weekends as needed
- Microsoft Word
- Microsoft Excel
- Medical office experience
- Paid holidays
- Disability insurance
Quick Apply
Eligibility Specialist I
Florida Cancer Specialists & Research Institute —Pensacola, FL
- Full-time
- Background check
- Microsoft Excel
- HIPAA
- Tuition reimbursement
- 401(k) matching
Referral Coordinator
Pensacola Lung Group —Pensacola, FL
- Overtime
- HIPAA
- English
- Mid-level
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13d

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ELIGIBILITY SPECIALIST I - 60055497
The State of Florida —Pensacola, FL
Learning numerous state and federal program regulations, through intensive training prior to full case assignment and then ongoing training thereafter.
$1,392.96 - $36,216.96 a year
Supervisory Medical Records Administration Specialist
US Military Treatment Facilities under DHA —Eglin AFB, FL
Continually review procedures to ensure that program meets federal, state and acknowledge accreditation and coding standards. Non-sensitive (NS)/Low Risk.
$89,508 - $116,362 a year
6d

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Utilization Specialist
Autumn Behavioral Health Center —Marion, OH
Collaborate with managed care organizations to facilitate authorization approvals and resolve any coverage issues promptly.
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4h
Insurance Verification and Prior Auth Specialist
Ohio Gastroenterology Group —Columbus, OH
Responds to patient calls about how out of network insurance is handled and provide patient with letter explaining this if necessary.
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11d

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Intake Specialist

Peoples Home Health, LLC -
Pensacola, FL

Quick Apply

Job Details

Benefits

Paid holidays
Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Microsoft Word
Microsoft Excel
Word embeddings
High school diploma or GED

Full Job Description

Description:

Why Peoples?
Peoples Health Services is the only family-owned, locally governed Hospice and Home Health provider in the Florida Panhandle. We believe that when we take care of the people who care for our patients, everyone benefits. We offer competitive pay, medical, dental, vision, group life, short-term disability benefits, a PTO program, 6 paid holidays, recognition programs, and work-life balance initiatives including a Relax & Recharge Day annually. Join a team that is dedicated to caring for our community—and each other.

Position Summary:

Is responsible for distributing admission information according to company policy; prioritizing phone calls; ensuring admission packets are available and appropriate; and interpreting insurance policy benefits to accurately reflect coverage amounts and Client co-pay (prior approval of insurance authorization). The Intake Specialist must be able to discuss and relay appropriate clinical information to obtain authorization for Home Care Services. They are also responsible for accurate data entry of referral data into HCMS. Abide by and demonstrates the company Mission, Vision, and Guiding Principles through both behavior and job performance on a day-to-day basis.

Essential Duties & Responsibilities:

Accurately enters all demographic, financial and referral data into the computer systems to facilitate billing and scheduling in a timely manner.
Answer phones and appropriately routes referral calls. Routes calls based on clinical needs.
Prioritizes phone call for follow up (i.e. doctors, insurance company)
Back up to Intake Supervisor by preparing the client referral for clinical in accordance with company policy, state and federal guidelines and private insurance contracts.
Appropriately prioritizes referrals so that the most urgent needs are met first. This includes consulting with CTM’s, schedulers, and referral sources for coordination of admission dates ad times.
Calculates co-pays and deductible amounts as per insurance reimbursement rates.
Completes all necessary documentation for initial authorization in accordance with the insurance company contracts.
Completes all request for all follow up authorization as needed, notifies staff of all authorizations received and visit limits as well as need to discharge client due to denial for further authorization.
Participates in communications and resolution of problems with insurance interpretation. Identifies insurance carriers and verifies benefits and eligibility.
Collaborates with CTM/Case Manager on authorized visit to assure accurate utilization for patient needs.
Follow up with AE/Liaisons via text or email to assure notification of referrals received and documentation needed.
Answer text or calls on weekends and after hours for insurance questions of new referrals.
Acts as backup to clinical staff and assist as necessary with copying, faxing, etc.
Demonstrates the ability to make customers feel satisfied and appreciated.
Maintains an understanding of the company’s scope of services.
Understands the infrastructure and how and where to transfer calls in the company.
Maintains a professional image.
Uses appropriate phone etiquette.
Promotes a customer friendly atmosphere for all visitors and ensures patient confidentiality at all times.
Participates in accreditation program.
Assist referral sources with finding placement for patient that company cannot accept due to insurance reasons.
Passes on all outstanding referrals and details to the nighttime/ weekend intake supervisor, via phone/ email.
Maintains daily referral report and sends out to assigned staff.
Performs other duties as assigned.

Working Conditions:

Office Environment. May be exposed to biological hazards.

Requirements:

Education/Experience:

Associates degree preferred,
High School Graduate (or equivalent) required.
Minimum three (3) years of prior experience in a medical field or medical office setting is preferred.
Knowledge of billing, insurance reimbursement, medical terminology, diagnosis coding preferred.
Experience with trouble shooting computer errors, maintaining records, and organizing is preferred.
Proficiency using Microsoft Word, and Excel is required.
Able to prioritize and manage time effectively and make independent decisions when necessary.

Quick Apply

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prior authorization specialist jobs in pensacola, fl

Intake Specialist

Eligibility Specialist I

Referral Coordinator

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