Associate Patient Access Rep- Prior Authorizations

Community Health Network; Indianapolis (IN); On-site; USD 38,000 - 55,000; Full time

Job summary

Community Health Network in Indiana seeks a Prior Authorization team member to obtain and manage insurance approvals for medical services, procedures and medications. You will collaborate with payers, providers and clinical staff to ensure timely approvals and accurate documentation.

You will review orders, verify benefits, track status and resolve denials, while maintaining compliance with policy and regulatory requirements to support efficient patient care and hospital revenue cycle.

Qualifications

• Minimum 2 years in customer service or healthcare office setting.
• Experience with prior authorization and medical documentation is a plus.
• Familiarity with Epic or similar health IT systems.

Responsibilities

• Obtain and submit prior authorization requests to payers.
• Review provider orders for medical necessity and completeness.
• Verify insurance benefits and authorization requirements.
• Communicate with payers, providers and clinical staff to obtain required information.
• Track authorization status and follow up to ensure timely approvals.
• Document authorization details accurately in the system.
• Resolve denials or incomplete requests by obtaining additional documentation.

Skills

Customer service

Healthcare office experience

Prior Authorization experience

Communication skills

Education

High School Diploma or GED

Tools

Epic Systems

Job description

Join Community

Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered - and we couldn’t do it without you.

Join Community

Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered - and we couldn’t do it without you.

The Prior Authorization team member

The Prior Authorization team member is responsible for obtaining and managing insurance authorization for medical services, procedures, and medications. This role ensures timely approvals, minimizes delays in patient care, and supports revenue cycle efficiency through accurate and compliant processing of authorization requests.

Exceptional Skills And Qualifications

• Two years of experience in customer service or healthcare office setting preferred.
• High School Diploma or GED required.
• Prior Authorization or Patient Access experience preferred.
• Experience with specialty services (radiology, surgery, infusion, etc.) preferred.
• Familiarity with Epic or other healthcare systems preferred.
• Initiate and submit prior authorization requests to insurance companies for services, procedures, and medications.
• Review provider orders and documentation to ensure medical necessity and completeness.
• Verify insurance benefits and authorization requirements.
• Communicate with payers, providers, and clinical staff to obtain required information.
• Track authorization status and follow up to ensure timely approvals.
• Document authorization details accurately in the system.
• Resolve denials or incomplete requests by obtaining additional documentation or appealing when appropriate.
• Maintain knowledge of payer policies and authorization guidelines.
• Collaborate with scheduling, registration, and clinical teams to prevent delays in care.
• Ensure compliance with organizational policies and regulatory requirements.

Why Community?

At Community Health Network, we build teams that deliver exceptional care through empathy, communication and collaboration. We consider ALL an integral part of the exceptional patient experience. We PRIIDE ourselves on not having employees but Caregivers. Join our Community as we make a difference in your community.