Find Jobs
Find Jobs Near You – Available Work in Your Location
Skip to job details
HM
Health Management Company of America, (HMCA)
Prior Authorization Specialist
Career Insights for Medical Claims Processor / Representative
See where this job fits in the broader career landscape. Knowing your career path helps you see what's possible from here.
Scorecard
Based on Florida data
Review key factors to help you decide if this role fits your goals. How is this calculated?
What they do
A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
$41,153 / year median in Florida
-3% projected decline
Job Description
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, clinical excellence, and operational efficiency to support optimal health outcomes. Overview The ideal candidate should be organized, detail-oriented, able to multitask, and have experience with insurance authorizations and medical office workflows (preferred). In this role, you will be responsible for managing insurance prior authorization processes, ensuring timely approvals for MRI medical services. The ideal candidate will possess strong knowledge of health insurance policies, and electronic health records management to facilitate seamless patient care coordination. Responsibilities Obtaining insurance authorizations for add-on services. Assisting with the authorization process to ensure timely approvals. Staying ahead of authorization requests and helping maintain an efficient workflow. Working closely with the clinical and administrative teams to minimize delays in patient care. Review and process insurance prior authorization requests accurately and efficiently Verify patient insurance coverage and eligibility using insurance portals. Communicate effectively with healthcare providers, insurance companies, and patients regarding authorization statuses Maintain detailed documentation of authorization requests, approvals and denials. Knowledge of health insurance , managed care processes, and insurance verification procedures Excellent customer service skills with the ability to communicate effectively. This position requires Level II background screening conducted by the Agency for Healthcare Administration. For further information, please visit http://info.flclearinghouse.com