Authorization Representative - Clearwater

Job Overview
We are seeking a dedicated and detail-oriented Authorization Representative to join our healthcare team in Clearwater. The ideal candidate will possess a strong understanding of managed care processes, medical office procedures, and insurance verification protocols. As an Authorization Representative, you will be responsible for managing referral and authorization requests, ensuring compliance with HIPAA regulations, and facilitating smooth communication between providers, insurance companies, and patients. Your role is vital in supporting efficient patient care delivery and maintaining accurate medical records.

Key Responsibilities

• Coordinate with appropriate primary care physicians and/or insurance companies to obtain referrals for office visits prior to the patient’s scheduled appointment.
• Ensure all authorizations are properly documented in the system.
• Advise patients of any potential problems concerning obtaining authorization prior to the scheduled appointment.
• Coordinate with the Billing/Collections department to research and obtain authorizations on previously denied claims.
• Utilize insurance websites (Availity, Humana Military (Tricare),United Healthcare, etc.) to obtain referrals/authorizations
• All other duties as assigned.

Qualifications:

• Candidate must be a high school graduate or GED.
• Experience in a medical environment preferred.
• Excellent customer service and communication skills.
• Able to multi-task.
• Excellent data entry skills.

Orthopaedic Solutions Management is a Drug Free Workplace

We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug-free workplace. All candidates will be required to undergo pre-employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy.

Pay: From $18.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Retirement plan
• Vision insurance

Work Location: In person