Central Authorization Specialist II

Join the team that is revolutionizing health care – BayCare Health System

Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility, and clinical excellence.

Our team members focus on tomorrow by achieving personal and professional success today. That's why you'll thrive in our forward-thinking culture, where we combine the best technology with compassionate service. We blend high-tech with high touch in ways that are advancing superior health care throughout the communities we serve.

Position: Central Authorization Specialist II

Facility: BayCare Central Billing Office / Remote

This Central Authorization Specialist II opportunity is a full-time remote (following onsite training) position. The team member must reside in Florida. The role requires onsite training in Clearwater, FL for at least 3-4 weeks.

The Central Authorization Specialist II job duties include:

• Performing intermediate-level authorization functions for inpatient, observation, and scheduled outpatient elective services
• Collaborates with patients, providers, and internal departments to ensure timely and accurate processing of authorizations and pre-certifications
• Uses revenue cycle and/or radiology information systems, payer websites, and recorded calls to validate insurance coverage and benefits
• Maintains thorough documentation and demonstrates a solid understanding of payer rules, manuals, and contract language
• Contributes to process efficiency and compliance
• Reviews provider orders and current procedural terminology (CPT) codes to verify the scheduled exam accurately matches the physician order
• Utilizes clinical terminology, exam protocols, and payer requirements to ensure the correct procedure is authorized, scheduled, and performed
• Identifies and resolves discrepancies to prevent delays, denials, or patient impact.

BayCare offers a competitive total reward package including:

• Benefits (Health, Dental, Vision)
• Paid time off
• Tuition reimbursement
• 401k match and additional yearly contribution
• Yearly performance appraisals and team award bonus
• Community discounts and more
• AND the chance to be part of an amazing team and a great place to work!

Minimum Qualifications:

Required Experience

• 2 years of Insurance verification and authorization retrieval or referrals required
  
• 1 year of Health Insurance Website required
• 1 year of healthcare business office and/or managed care experience is preferred

Education:

• HS Graduate or Equivalent GED required
• Associate's Degree preferred

Location: Clearwater, FL

Status: Full Time

Shift Hours: 8:00 AM - 4:30 PM or 8:30 AM - 5:00 PM

Weekend Work: Occasional

Equal Opportunity Employer Veterans/Disabled