About Our Company

Advanced Diabetes Supply was founded on the bold principle of creating a knowledgeable, reliable and demonstrably superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has catapulted Advanced Diabetes Supply to a national leader in the industry. Creating high-performance, adaptive teams requires a relentless commitment to hiring the best. We strive to maintain a casual, fun environment whenever possible, but we don't just play around. We work hard every day to provide a positive work culture and respectful atmosphere. The standards we set for ourselves are high, and we love to be challenged! If you enjoy working in a collaborative environment, have a passion for excellence and a bias for action, we may be just what you've been looking for.

Interested in learning more about our company and its culture? Visit us at www.northcoastmed.com

About The Position

Hours: 8:00 AM to 4:30 PM ET, Monday through Friday with one Saturday each month from 10:00 AM to 2:00 PM ET

Location: Hybrid in Doral, FL

The Prior Authorizations Specialist I is responsible for the initiation of the prior authorization process for medical procedures, medications, and other healthcare services. This entry-level role involves working closely with healthcare providers, insurance companies, and patients to ensure timely approval for treatments.

Essential Functions

• Review incoming authorization requests and verify patient eligibility and benefits.
• Initiates prior authorization requests via phone, fax, or online portals.
• Tracks and follows up on the status of submitted authorizations.
• Communicates approval or denial outcomes to healthcare providers and patients.
• Maintains accurate records and documentation of all authorization activities.
• Collaborates with the billing and clinical teams to ensure the accuracy of information.
• Complies with HIPAA rules, appropriately safeguarding PHI or other private & confidential information.
• Maintains accurate and detailed notes in the company system.
• Adapts quickly to frequent process changes and improvements.
• Is reliable, engaged, and provides feedback to improve processes and policies.
• Attends all department, team, and weekly company meetings as required.
• Appropriately routes incoming calls when necessary.
• Meets company quality standards.
• Embraces and exemplifies ADS core values:
  • We put our people first.
  • We serve our members with passion.
  • We take ownership.
  • We pursue excellence.
  • We never stop growing.

Other Responsibilities

• May perform any additional responsibilities or special projects as required.
• Duties and responsibilities may be subject to change based on the needs of the department.

• High School diploma or equivalent
• Knowledge of insurance, billing, and processing claims
• Basic knowledge of insurance portals; familiarity with a variety of medical and/or insurance terms or practices
• Proficiency in basic math and business calculations
• Working knowledge of computer/data entry with the ability to learn new systems
• Basic level of MS Office proficiency

Expected Competencies

• Friendly, professional, and effective communication skills; able to calmly present solutions in challenging situations.
• Proactive identification of challenges, and solution-oriented approach to problem solving.
• Service orientation and aptitude to aptitude to resolve insurance and/or patient matters.
• Effective analytical skills: able to use inductive and deductive reasoning to anticipate outcomes.
• Self-directed accountability and reliability
• Effective communication, and interpersonal skills, with the ability to influence and collaborate effectively with cross-functional teams.
• Able to manage and prioritize multiple tasks/projects, work autonomously, and meet deadlines.
• Able to work well in a team environment that promotes inclusiveness and communication among team members.
• Communication using both verbal and written English proficiency.
• Cultural competence

Physical Demands

The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable employees with disabilities to perform the essential functions.

While performing the responsibilities of the job, the employee is required to remain in a stationary position most of the time (stand or sit). While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is frequently required to stand, walk, and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

Other Requirements

• Candidates must successfully pass a background check.
• Candidates must be able to provide proof of eligibility to work in the United States.

Pay Range and Compensation Package

Pay ranges may vary depending on location. Actual compensation depends on education, experience, and relevant skills. In addition, benefits include:

• Health, Dental & Vision options
• FSA and HSA plan with Employer Contribution
• Employer paid EAP
• 401k with 4% Company Match
• Discretionary Profit-Sharing Plan
• Paid Time Off (PTO) Including 7 Paid Holidays and a Birthday Holiday
• On-Site Gym
• In-house Training Programs
• A fun culture in a fast-growing organization!

Equal Opportunity Statement

Advanced Diabetes Supply provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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