The Authorization Specialist coordinates and secures insurance pre-certifications and pre-authorizations for medical procedures, outpatient testing, and prescribed medications. The role acts as a liaison between providers, insurance carriers, patients, and external agencies to help ensure timely access to care and accurate documentation in the electronic medical record (EMR).
Key responsibilities include obtaining authorizations, coordinating workflows, scheduling outpatient services, documenting authorization details, triaging patient communications, educating patients on authorization processes, and supporting peer-to-peer reviews and appeals when needed.
Qualifications
- High school diploma or GED
- At least 6 months of medical office experience, including authorization or pre-certification work
- Knowledge of medical terminology
- Knowledge of CPT and ICD-9 coding
- Strong written and verbal communication skills
- Ability to document accurately in an electronic medical record
- Ability to manage multiple authorizations, appointments, and deadlines in a fast-paced environment
- Understanding of pre-certification, prior authorization, and referral requirements across commercial, Medicare, and Medicaid plans
Location
Tampa, Florida, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 month ago