Managed Care Prior Authorization Specialist Job at Spine Institute of Central Florida, Lakeland, FL

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  • Spine Institute of Central Florida
  • Lakeland, FL

Job Description

Job Description

Job Description

Job description

We are seeking a prior authorizations individual to add to our well established authorization team.

Responsibilities:

  • Obtain pre-authorizations/pre-certification per payer requirements for services rendered and ensures authorization information is documented in the appropriately in the system
  • Process authorization requests in a timely manner
  • Obtain accurate patient information and enter required information (non-clinical and structured clinical data) into the computer database
  • Provide excellent customer service to all internal and external customers
  • Maintain communication with the providers, clinical staff, and patients in relationship to authorization status
  • Answer calls from physician offices, hospitals, insurance companies, and patients using exemplary customer service skills
  • Contact various clinics, facilities, and companies to obtain information to accurately complete authorization requests in a timely manner

Qualifications:

  • Mastery on navigating insurances as well as helping patients obtain authorization for, but not limited to, Spinal and extremity injections, office visits, Advanced imaging including MRI, CT Scans, etc, Physical Therapy, interventional spine procedures and surgeries.
  • Candidate must be well versed in obtaining routine authorizations, stat authorizations, and multi-visit appointment authorizations.
  • Familiarity with workers compensation a plus
  • Must have familiarity with what to do with authorization denials and pathways to submit for, check up on and confirm approvals.
  • Arrange and maintain patient appointments to include surgery appointments.
  • Candidate must be 100% reliable and dependable. Candidate must be upbeat and energetic and work well with the authorizations team.
  • Good, friendly and professional rapport with patients, providers and co-workers.

Must have 1+ years of prior authorizations experience., preferably including procedures, stat situations, and surgical level of care experience.

Company Description

The Comprehensive Spine Center at Spine Institute of Central Florida provides a full scope of Spinal services. We specialize in the entire spectrum of non-surgical and surgical care of the spine. For your convenience, all services are available under one roof; including very effective and highly sophisticated spinal evaluation and treatment programs, diagnostic imaging, interventional pain management, spine specialized rehabilitation and therapy programs specially designed for specific spinal conditions and injuries to ensure maximal results.

Company Description

The Comprehensive Spine Center at Spine Institute of Central Florida provides a full scope of Spinal services. We specialize in the entire spectrum of non-surgical and surgical care of the spine. For your convenience, all services are available under one roof; including very effective and highly sophisticated spinal evaluation and treatment programs, diagnostic imaging, interventional pain management, spine specialized rehabilitation and therapy programs specially designed for specific spinal conditions and injuries to ensure maximal results.

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