Authorization Associate, Patient Access, FT, 08:30A-5P

Baptist Health Authorization Specialist

The incumbent will be responsible to request, follow-up, obtain, and validate authorizations/referrals/notifications with appropriate CPT and ICD-10 codes, within the appropriate timelines. This position requires the incumbent to be in a call center type environment and responsible for meeting individual quality metrics. Responsible for coordinating patient flow, timely processing, maintaining knowledge and deployment of practices used within the department/physician practice/hospital to address patient questions or concerns. Maintaining knowledge of insurance requirements, BHSF pricing, financial assistance options, and overall BHSF Revenue Cycle operations. Assist in supporting go lives and different departmental initiatives, including onboarding and training team members. Participate in departmental committees/champion opportunities. Practices the Baptist Health philosophy of service excellence in providing professional, compassionate and friendly service to patients of all ages, families, employees, physicians and community members.

Qualifications:

Degrees:

• High School,Cert,GED,Trn,Exper.

Additional Qualifications:

• For internal staff: A minimum of 2 years experience in validating/obtaining authorizations with insurance payers and has demonstrated the ability to independently perform all functions within the Level 1 job description.
• Meets/exceeds all Individual Performance Standards for at least the most recent 6 months.
• Exceeds departmental KPIs and is cross trained in multiple areas/product lines to substitute all staff positions as needed.
• For external staff: Associates Degree preferred with 2 years experience in validating/obtaining authorizations with insurance payers, or 3 years experience in lieu of degree.
• Complete and pass the Patient Access training course.
• Ability to work in a high volume, fast-paced work environment, and perform basic mathematical calculations.
• Detail oriented, organized, team player, compassionate, excellent customer service and interpersonal communication skills.
• Desired: Knowledge of healthcare regulatory guidelines to include, but not limited to, HIPAA, AHCA, EMTALA, Medicare coverage structure, including medical necessity compliance guidelines.
• Understanding of insurance contracts, collections, authorizations, and pre-certifications, Microsoft Office products, and EMR applications, etc.
• Knowledge of medical terminology.
• Bilingual English, Spanish/Creole.

Minimum Required Experience:

• Associates Degree preferred with 2 years experience in validating/obtaining authorizations with insurance payers, or 3 years experience in lieu of degree.

EOE, including disability/vets