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Authorization Specialist I

Baptist Health Care

Pensacola, Florida

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JOB DETAILS
SKILLS
Claims Processing, Clinical Study Publications, Content Management Systems (CMS), Customer Support/Service, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Healthcare Providers, Hospital, Leadership, Medical Terminology, Nonprofit, Orthopedics, Patient Care, Patient Care Authorizations, Pharmacy, Primary Care, Quality of Life, Regulatory Requirements, Sports Medicine
LOCATION
Pensacola, Florida
POSTED
16 days ago
JOB DESCRIPTION

The Authorization Specialist serves as the point of financial clearance for the Infusion Center. The Authorization Specialist obtains authorization for infusion and/or radiation service on behalf of BPE providers. The team member verifies appropriate order is received, insurance is verified, as well as request authorization on their behalf- including submission of clinical documentation. Authorization Specialists work closely with practice leadership along with department leadership regarding needs to ensure appropriate clearance. Authorization Specialists contact patients regarding rescheduling needs and communicate with ordering providers and servicing departments. Authorization Specialists verify authorizations received from external referral sources to Infusion and verify benefits of the patient. In conjunction with pharmacy partnership, Authorization Specialists communicate drug changes as needed for assistance programs. This position will work directly with practice leadership. In order to ensure superior service and appropriate patient care, all pre-appointment requirements including scheduling, authorization, price estimation, financial counseling and pre-registration will be coordinated by this position.

RESPONSIBILITIES

  • Accountable for verification of benefits for all BH Infusion Department Services.
  • Monitors, documents and completes any insurance authorization and/or verification (benefit) requirements.
  • Ensure BHC has accurate and current information to process claims and to obtain payment including complete review of financial clearances.
  • Understands all regulatory agency requirements (i.e. Joint Commission, HIPPA, EMTALA, OIG, and CMS, etc.) as it relates to software under PASS' management.


QUALIFICATIONS

Minimum Education
  • High School Diploma or Equivalent Required

Minimum Work Experience
  • 1-3 years Registration, customer service, and/or scheduling experience with medical terminology experience Preferred


ABOUT US

Baptist Health Care is a not-for-profit health care system committed to improving the quality of life for people and communities in northwest Florida and south Alabama. The organization includesthree hospitals, four medical parks,Andrews Institute for Orthopaedic & Sports Medicine, and an extensive primary and specialty care provider network. With more than 4,000 team members, Baptist Health Care is one of the largest non-governmental employers in northwest Florida.

Baptist Health Care, Inc. is an Equal Opportunity Employer. BHC maintains and enforces a policy that prohibits discrimination against any workforce members or applicants for employment because of sex, race, age, color, disability, marital status, national origin, religion, genetic information, or other category protected by federal, state or local law. Certain positions may require a Level 2 Background check through AHCA. Additional information about this requirement can be found here: Florida Care Provider Background Screening Clearinghouse

About the Company

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Baptist Health Care

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