Authorization Representative

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

• Provides backup to all front office positions, including check-in, check-out, and medical records.
• Obtains authorizations within the hospital and clinic setting.
• Reviews insurance verification and completes the authorization process within established time frames, accurately entering data into software programs.
• Receives coverage authorization and works diligently to meet established timelines, including obtaining authorizations for same-day procedures.
• Works closely with doctors and team members to support efforts to accomplish authorization/verification for both routine and STAT orders.
• Arranges and oversees peer-to-peer authorizations between specialists and insurance companies.
• Requests authorization from insurance companies and hospital departments to provide specific services and parameters of care.
• Serves as liaison between clinic and specific areas of the hospital to assure timely authorization and provision of services.
• Provides effective communication to patients, families, team members, and other healthcare professionals while maintaining confidentiality.
• Assists in correcting claim denials and provides assistance to patients in understanding their financial responsibility.
• Adheres to all company policies and procedures.
• Obtains necessary demographic, diagnostic, and insurance information, as well as clinical information required to request prior authorizations.
• Other duties as assigned.

• Demonstrated effective communication and interpersonal relation skills [Required]
• Demonstrated computer experience using word processing and data entry software [Required]
• Must be able to type 30 wpm and know 10-key by touch [Required]
• Strong Organizational Skills [Required]
• Ability to adhere to strict timelines [Required]
• Multi-tasking skills [Required]
• Proficiency in EMR and EPM [Required]
• Previous insurance verification experience [Required]
• Proficiency in Medical Terminology [Required]
• Previous customer service work experience [Required]
• Problem Solving Skills and Attention to Detail [Required]
• Knowledge of ICD-10 and CPT coding [Required]
• Knowledge of payer requirements for authorization and billing [Required]

• High School Grad or Equiv [Required]

• 1+ years of authorization experience [Required]
• 3+ insurance verification experience [Required]

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.