What are the responsibilities and job description for the Medical Insurance Verification Specialist position at Health Management Company of America, (HMCA)?
Company Overview
Health Management Company of America is dedicated to providing comprehensive healthcare services through state-of-the-art facilities and a patient-centered approach. Our organization emphasizes quality care, efficient operations, and adherence to industry standards to ensure optimal patient outcomes.
Job Overview
We are seeking a detail-oriented and proactive Health Insurance Verification/ Prior Authorization Specialist to join our healthcare team. In this role, you will be responsible for managing prior authorization requests for various medical out-patient radiology MRI exams, ensuring timely approvals, and maintaining compliance with insurance policies and regulations. The ideal candidate will possess strong knowledge of managed care processes, medical terminology, and office procedures to facilitate seamless authorization workflows.
Duties
- Review and process prior authorization requests for medical procedures, ensuring completeness and accuracy.
- Verify insurance coverage, benefits, and eligibility through insurance portals or direct communication with carriers.
- Collaborate with healthcare providers to obtain necessary documentation and clarify authorization requirements.
- Maintain detailed records of authorization statuses, correspondence, and related medical records in compliance with HIPAA regulations.
- Utilize CPT coding, ICD-9, ICD-10, and ICD coding systems to accurately document procedures and diagnoses for authorization purposes.
- Follow up with insurance companies on pending requests to expedite approvals or resolve issues promptly.
- Ensure adherence to managed care guidelines, HIPAA standards, and office policies throughout the authorization process.
Experience
- Prior experience working in a medical office environment is highly preferred.
- Strong understanding of managed care processes, insurance verification, and medical billing procedures.
- Familiarity with CPT coding, ICD-9, ICD-10 coding systems, and medical terminology.
- Knowledge of medical records management and medical coding practices.
- Experience handling prior authorizations within a fast-paced healthcare setting.
- Excellent organizational skills with attention to detail and accuracy in documentation.
- Ability to communicate effectively with providers, insurance representatives, and patients while maintaining professionalism. This position offers an opportunity to contribute significantly to our operational efficiency by ensuring timely access to necessary healthcare services while maintaining compliance with industry standards. We welcome candidates committed to excellence in healthcare administration and patient support.
This position requires Level II background screening conducted by the Agency for Healthcare Administration. For further information, please visit http://info.flclearinghouse.com
Pay: $16.50 - $19.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Application Question(s):
- Please describe your experience with prior authorizations for MRI radiology.
Work Location: In person
Salary : $17 - $19