AUTHORIZATION REPRESENTATIVE

Full Time
Clearwater, FL 33756
Posted
Job description

At FOI our goal is to provide our patients with world-class orthopedic care.

Our mission of providing the best care encompasses not only the care the physician provides, but all medical and administrative aspects of the patients encounter with Florida Orthopaedic Institute (FOI) as well. Every staff member plays a vital role in this mission. We take pride in receiving the Patriot Award from the Department of Defense for the support that we give to National Guard and Reserve members who are employed by FOI. We are committed to encouraging a culture of inclusion reflective of the communities we serve, and we provide equal opportunity to all. Florida Orthopaedic Institute conforms to the spirit as well as to the letter of all applicable laws and regulations.

What we offer:

  • Full time opportunities available, with room for career growth and advancement.
  • Excellent job security and stability, to promote an optimal work life balance.
  • Be part of this dynamic and growing high level Patient Services team!

In this role you will:

Be responsible for accurately and efficiently obtaining and documenting all referrals and authorizations to ensure all patients are authorized for the physician, the date of service and all anticipated services Referrals and Authorizations are obtained by contacting physician’s offices, insurance companies, and/or the patient.

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.
  • Coordinate with the Benefit Verification Rep to confirm benefits when problems occur.
  • Utilize insurance websites (Availity, Humana Military (Tricare),United Healthcare, etc.) to obtain referrals/authorizations.
  • Assure compliance with all company plans, policies and procedures set forth by the Florida Orthopaedic Institute
  • All other duties as assigned.

About You:

  • High School Diploma
  • 2 years experience in a medical clinic or health insurance
  • Intermediate data entry skills
  • Excellent customer service and communication skills.

We Would Love It If You Also Had:

  • athenaNet experience

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