Medical Insurance/ Prior Authorization Specialist

Jacksonville, FL 32224

Posted: 09/28/2018 Industry: Other Area(s) Job Number: 31708

Medical Insurance/ Prior Authorization Specialist 

Verify insurance benefits and coverage for testing, procedures, and surgical cases. Obtain prior authorizations and/or pre-determinations for various procedures.

Collects, reviews, discusses, and documents demographic, insurance, and financial information with patients and payers Revenue Cycles. Responsible for management and collection of Account Receivables through the use of automated systems and revenue cycle processes. Responds to and resolves a variety of account, billing and payment 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 patient. 

Qualifications:

Must have experience obtaining Prior Authorizations.

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.  

Hours: M-F 8a-5p
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