Authorization/Eligibility/Patient Service Rep - On Site

Job Description

Job Description

On-Site position only.  Eye Site of Tampa Bay is a multi-specialty ophthalmology practice focused on excellence in patient care and creating exceptional patient experiences. We offer great pay and benefits in an exceptional team work  environment. The Authorization Specialist is the primary source for verifying insurance eligibility and benefits, securing referrals and prior-authorizations, creating predictive financial agreements, and assisting in other Front Desk, Optical and Billing projects. Exciting opportunity!  M-F, days, EOE.

• Uses eligibility tools, and is capable of checking benefits through Availity, UHC Provider/Humana Military and other payer websites.
• Obtains routine eye benefit authorizations.
• Contacts insurance carriers to verify coverage and limits as directed by policy.
• Initiates financial agreements for high-deductible health plans and co-insurances.
• Obtains appropriate prior authorizations relevant to date of service and procedure, including same day/add-on procedures, surgeries and testing.
• Contacts patients regarding balance due at time of service, and effectively communicates insurance coverage limits to patients.
• Documents all communication with patients in Practice Management system.
• Provides coverage for Front Desk, as scheduled.
• Participate fully as a team member in a dynamic, patient-focused, fast-paced environment.
• Researches accounts, and works with billing team to resolve claim issues.
• Participates and assists in in-house collection projects, as assigned.
• Participates and assists in special billing projects, as assigned.

Required Skills & Abilities:

• Experience in insurance eligibility, prior authorizations and referrals in a health care setting.
• Knowledgeable in use of Availity, UHC Provider/Humana Military websites.
• Knowledgeable of CPT/ICD-10 coding; ophthalmology experience, a plus.
• Detail-oriented with excellent organizational and time management skills.
• Excellent communication skills, both verbal and written.
• Proficiency with Microsoft Word and Excel.
• Positive attitude and demeanor.
• Ability to work in a fast-paced environment.
• Experience using a PM and EHR system (Nextech/MDI,a plus).
• Must be able to pass background and drug screening.

Excellent benefit package to include PTO, health/dental insurance, 401k. Outstanding work environment. Salary commensurate with experience.