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. 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

A minimum of 1 year experience in validating/obtaining authorizations with insurance payers.
Complete and pass the Patient Access training course.
Ability to work in a high volume, fast-paced work environment.
Ability to perform basic mathematical calculations.
Detail oriented, organized, team player, compassionate, excellent customer service and interpersonal communication skills .
Desired: Knowledge of medical and insurance terminology.
Experience with computer applications (e.g., Microsoft Office, knowledge of EMR applications, etc.) and accurate typing skills.
Knowledge of regulatory guidelines to include, but not limited to, HIPAA, AHCA, EMTALA, etc.
and Medicare coverage structure, including medical necessity compliance guidelines.
Bilingual English, Spanish/Creole.

EOE, including disability/vets