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Referral & Authorization Coordinator na None

None · West Palm Beach, Estados Unidos Da América · Onsite

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We are looking for a energetic, hard-working, dependable, multi-tasking Medical Insurance Authorization specialists who are passionate about helping others and making a difference. 

DUTIES AND RESPONSIBILITIES:   

  • Verifies information provided by referring physicians and verifies insurance coverage. 
    • Analyze patient records and insurance policies to determine if procedures, treatments, or medications require prior authorization
    • Ensure patients are eligible for services and that insurance benefits are accurate 
    • Interacts with healthcare providers, insurance companies, and patients to obtain and provide information needed for authorization decisions
    • Notify providers of potential coverage options
    • Communicate with patients about the authorization process and any potential delays or financial implications. 
    • May suggest formulary/cheaper alternatives for expensive drugs. 
    • May investigate any serious drug interactions with the requested drug.  
  • Completes authorizations and referrals for our medical services, including appointments and procedures. 
    • Input new patient information and update information in our system
    • Compile and submit detailed authorization requests to insurance companies, including all necessary documentation
    • Research and resolve any issues or discrepancies related to authorization requests
    • Monitor and follow up on authorization requests to ensure timely processing
    • Investigate insurance denials and resubmit requests or appeal when necessary. 
    • Complete billing documentation
  • Monitors the schedule for add-on patients, ensuring no conflicts, and we have required prior authorization to move forward with appointment or procedure.
  • Remain informed about healthcare industry regulations, trends and insurance policies
  • Assist with other clerical tasks as needed and perform other related duties as assigned by management.  


QUALIFICATIONS:  

  • High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience.   Associate degree a plus. 
  • Some experience in medical billing or insurance authorization (strongly preferred).
  • Knowledge of medical terminology.
  • Basic computer skills.
  • Attention to detail.

JOB TYPE / WORK SCHEDULE:

  • This is a full-time position, in-office position
  • Standard office hours, Monday - Friday 8:00 AM - 4:30 PM
  • Bilingual Required

Competitive pay 401(k) Dental Insurance Health insurance Life insurance Vision insurance 

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