Authorization Associate 2, BHMG Ortho- Pinecrest Position Available In Miami-Dade, Florida
Tallo's Job Summary: The Authorization Associate 2 position at BHMG OrthoPinecrest in Pinecrest, FL offers an estimated salary of $36.8K to $46.4K a year. Qualifications include fluency in Spanish, customer service skills, and knowledge of Medicare pricing. The role involves requesting and validating authorizations with insurance payers, maintaining knowledge of insurance requirements, and supporting departmental initiatives. Internal staff must have at least 2 years of relevant experience, while external staff should ideally have an Associate's Degree and 2 years of experience in the field. Knowledge of healthcare regulatory guidelines and medical terminology is desired for this position.
Job Description
Authorization Associate 2, BHMG Ortho•Pinecrest Baptist Health Medical Group•4.1
Pinecrest, FL Job Details Estimated:
$36.8K•$46.4K a year 8 hours ago Qualifications Bilingual Spanish Pricing Medicare Customer service English Mid-level Microsoft Office High school diploma or
GED ICD-10 CPT
coding Contracts Associate’s degree Medical terminology 2 years Communication skills Full Job Description Baptist Health is the region’s largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 25 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, and in the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients’ shoes ourselves and that shared experience fuels out commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact•because when it comes to caring for people, we’re all in.
Description:
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:
EOE, including disability/vets
