At InSync Healthcare Solutions, we have a story to tell…We have quickly grown to become the industry’s leading Electronic Medical Record software provider in the US. We know that our quest to be best requires many dynamic and dedicated professionals in every area throughout our organization. We work hard, have fun, and continually invest in our team members futures. With rewarding career paths, continued learning and internal promotions, we have created a corporate culture that allows you to grow personally and professionally. As we focus on our future, we are seeking:
Insurance Authorization Specialist
Tampa, FL Headquarters
The Insurance Authorization Specialist is responsible for verifying patient eligibility, obtaining prior authorizations, and maintaining patient authorizations. Knowledge of medical terminology is beneficial.
- Identifies patient pre-authorization/referral requirements and ensures they are met and in place in a timely manner to facilitate efficient billing and payment for multiple specialties
- Tracks and follows up on all pending authorizations depending upon payer guidelines
- Processes authorizations in a variety of methods, working with the payers to secure authorizations
- Verifies authorization quantities and effective dates are returned and processed correctly by the payers, and loaded correctly in all systems
- Organizes work to avoid lost revenue due to filing limitations
- Identifies opportunities to improve authorization efficiencies electronically via Availity, payer portals, etc.
- Review Outpatient and Inpatient accounts to identify if notification, authorization and/or referrals are required and obtains prior to service being rendered and within payer guidelines
- Reviews and submits authorization, referrals, and other medical necessities timely to ensure that patients can keep scheduled appointments, while following departmental procedures
- Facilitates timely telephone calls and online inquiries regarding status of outstanding referrals and/or authorizations and notifications
- Reviews, rectifies, and clears individual and batch Worklist errors and alerts to ensure account quality and accuracy
- Identifies accounts that have been postponed or cancelled and removes authorizations that are no longer valid and request updated authorizations
- Troubleshoots insurance denials and billing discrepancies and prepare paperwork for appeal submission regarding prior authorizations
- Associate degree (AA) or equivalent (one year) experience
- Work experience in both billing and collections
- A minimum of one year in Patient Access/Patient Registration, Patient Accounts, or a physician’s office in which the candidate directly managed verification of eligibility, obtaining referrals and authorizations, and/or registration of demographic and insurance information
- Knowledge of and ability to explain concepts of medical benefit plan design
- Excellent organizational, teamwork, and time management skills
- Highly motivated and detail-oriented
- Good troubleshooting skills
We InVest in you!
The things that make you unique, are the same things that make us successful. Your talents, creativity and ideas help full our success. We reward your individuality and talents with low and no cost healthcare, generous PTO program, Life, dental and vision insurance, short and long term disability, 401k and many other perks to ensure your career satisfaction. And that’s just the beginning… you’ll also enjoy Fido Fridays, Team outings, Food Truck Fridays, and so much more! If you thrive in an environment that encourages your individuality, ideas and growth, we encourage you to apply today .
InSync Healthcare Solutions is proud to be an equal opportunity employer.