Insurance Authorization Coordinator I – Casual

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🔥 15 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏱ Part Time

🟢 Junior

🔒 Insurance

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Center for Health Care Strategies

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 1998

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

Center for Health Care Strategies is a U. S. -based organization dedicated to improving the healthcare system to achieve better and more equitable outcomes, particularly for those served by Medicaid. The center focuses on issues like complex health and social needs, mental health, substance use, and aging and disability. It emphasizes cross-sector partnerships, community engagement, and health equity to transform the delivery system and promote value-based payments. The organization also supports leadership and capacity building efforts to drive system reform, including integrating Medicare and Medicaid services and advocating for trauma-informed care and primary care innovation.

📋 Description

• Obtain authorizations for hospital-based and/or physician-based services • Use workqueues and other mechanisms to initiate authorizations and referrals, follow up on requests, monitor appointment add-ons, and document changes • Complete authorizations and referrals according to departmental goals and guidelines • Verify insurance eligibility, authorization requirements, plan benefits, and patient financial responsibility • Process appointment add-ons, schedule changes, date changes, and impactful service changes requiring immediate review • Review clinical documentation and submit necessary information to payers • Maintain accurate records of authorization requests, approvals, denials, correspondence, patient information, and insurance details • Communicate authorization status to patients, families, healthcare professionals, and other stakeholders • Collaborate with providers, physicians, clinical staff, Central Business Office, Financial Services, Transport, Patient Cost Estimation, Managed Care, Utilization Review, and other departments • Identify authorization barriers, resolve denials, appeal decisions, and find alternative solutions • Participate in daily departmental huddles and report payer issues, workflow barriers, and risks of non-reimbursable or canceled services • Maintain professional relationships with specialty department contacts and provide customer service • Follow applicable laws, regulations, privacy guidelines, and organizational policies

🎯 Requirements

• One year of specialized training beyond high school • Minimum of 6 months of insurance authorization experience required • Ability to request and obtain preauthorization for assigned specialties and cover other workflows, including workqueue items • Ability to submit required documentation and follow up to ensure timely approvals • Knowledge of insurance policies, guidelines, authorization, and reimbursement procedures • Ability to verify insurance coverage, eligibility, demographics, benefits, and financial responsibility • Ability to identify prior authorization and predetermination requirements • Ability to review clinical documentation for information needed by payers • Accurate documentation and record-keeping skills • Ability to communicate with patients, families, healthcare professionals, and internal departments • Ability to identify barriers, resolve denials, appeal decisions, and find alternative solutions • Organized, able to work effectively in a virtual team environment, solve problems, and seek assistance when needed • Excellent, empathetic, and knowledgeable customer service skills • Ability to comply with laws, regulations, privacy guidelines, and organizational policies