Looking for a change?
We are adding to our Revenue Cycle Management team in St. Petersburg, FL!
At Clear Sight Partners, we are building the region’s premier destination for comprehensive vision care. We are a team of over 130 optometrists, ophthalmologists, surgeons, opticians, and eye care professionals serving more than 100,000 patients across 15 different locations in the Greater Tampa Bay area. From routine eye exams and optical retail, to medical optometry, ophthalmology, and surgical procedures, our patients experience end-to-end personalized care and service.
The Prior Authorization Specialist is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers, transcribes and triages patient calls to physicians, and coordinates patient appointments/orders.
Essential Functions and Responsibilities
Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.Request, follow up and secure prior authorizations prior to services being performed.Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.Communicate any insurance changes or trends among team.Maintains a level of productivity suitable for the department.Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.Other duties as assigned.
- Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
Medicaid, Medicare, and other third-party payor reimbursement guidelines and requirementsExperience working with confidential medical informationExperience in computer programs such as EMRs, Word, Excel
- Minimum of 2 years of performing pre-authorization in a clinic or similar setting
Skills and Abilities
Highly organized with developed time management skillsExcellent customer service and telephone etiquetteExcellent verbal and written communication skillsStrong research and problem-solving skills; attentive to detailsAbility to operate a computer and general office machinesMust be self-directed, able to work independently, as well as work in a team-oriented and fast paced environmentAbility to clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
- Ability to navigate various websites and carrier portals
Medical, Dental, Vision insurance benefits401k and 401k Match
- Paid Time Off and 8 Paid Holidays