Medical Insurance Specialist
13901 Sutton Park Dr. S, Suite 220 Jacksonville, Florida 32224
Medical Insurance Specialist - Prior Authorizations
The Medical Insurance Specialist is responsible for obtaining prior authorizations. This role obtains prior authorizations from insurance companies for a variety of hospital based testing and procedures. Responds to and resolves a variety of account issues from patients and customers. Follows approved guidelines and policies regarding routine patient and payer interactions. Makes independent decisions that require individual and/or team analysis, reasoning, and problem solving. Interprets, applies and communicates policies regarding medical and financial aspects of patient care to assure optimal reimbursement for both the patient. This individual must accurately document interactions and interpret interactions documented by others. Must have excellent customer service skills.
Pre-Certification, Prior Authorization experience required
Must have excellent customer service skills and possess the ability to negotiate payment reimbursement from patients and third party payers, via incoming and outgoing phone calls or face to face interactions.
Minimum HS Diploma or GED required
Hours M-F 8-5