Authorization Specialist

violet health; Sylvan Lake (MI); On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

401(k) starting January 2026

Paid time off (PTO) and holidays

Ongoing training and professional成长

Job summary

Violet Health is seeking a proactive Patient Intake & Prior Authorization Specialist to manage front-end onboarding and coverage approvals. You will verify eligibility, register referrals, and coordinate with clinical teams and payers to secure authorizations.

In this role, you will handle intake, insurance verification, and authorization submissions while ensuring clear communication with patients and adherence to HIPAA guidelines. Opportunity for growth within a patient-centered care team.

Qualifications

• 2+ years of experience in healthcare intake, patient access, prior authorization, or medical billing.
• Deep understanding of prior authorization workflows and payer portals.
• Experience with EHR/PM platforms (Epic, Athenahealth, Cerner or Kareo).

Responsibilities

• Intake & Registration: Accurately collect and enter demographic, clinical, and insurance information for new and returning patients into the EHR system.
• Insurance Verification: Verify active coverage, copayments, coinsurance, deductibles, and network status across commercial plans, Medicare, and Medicaid.
• Prior Authorization Management: Prepare, submit, and track prior authorization requests for specialist consultations, procedures, diagnostic tests, and pharmaceuticals according to payer-specific criteria.
• Clinical Coordination: Collaborate with physicians, nurses, and medical assistants to obtain necessary clinical documentation, chart notes, and letters of medical necessity.
• Denial Resolution & Peer-to-Peer Support: Monitor pending authorization requests, identify root causes for initial coverage denials, assist in drafting appeals, and schedule peer-to-peer clinical reviews when needed.
• Patient Communication: Keep patients informed regarding the status of their authorizations, explain coverage limitations or out-of-pocket responsibilities clearly, and maintain compassionate customer service.
• Compliance & Recordkeeping: Adhere strictly to HIPAA guidelines, payer compliance timelines, and organizational protocols for document handling.

Skills

Communication

Phone etiquette

Attention to detail

Multitasking

Education

High school diploma

Associate degree

Medical certification

Tools

Epic

Athenahealth

Cerner

Kareo

Availity

CoverMyMeds

Job description

We are seeking a proactive, highly organized Patient Intake & Prior Authorization Specialist to manage the front-end patient onboarding and coverage approval process. In this dual-focus role, you will verify patient eligibility, register incoming referrals, secure insurance prior authorizations, and coordinate directly with clinical teams and third-party payers.

Key Responsibilities

• Intake & Registration: Accurately collect and enter demographic, clinical, and insurance information for new and returning patients into the Electronic Health Record (EHR) system.
• Insurance Verification: Verify active coverage, copayments, coinsurance, deductibles, and network status across commercial plans, Medicare, and Medicaid.
• Prior Authorization Management: Prepare, submit, and track prior authorization requests for specialist consultations, procedures, diagnostic tests, and pharmaceuticals according to payer-specific criteria.
• Clinical Coordination: Collaborate with physicians, nurses, and medical assistants to obtain necessary clinical documentation, chart notes, and letters of medical necessity.
• Denial Resolution & Peer-to-Peer Support: Monitor pending authorization requests, identify root causes for initial coverage denials, assist in drafting appeals, and schedule peer-to-peer clinical reviews when needed.
• Patient Communication: Keep patients informed regarding the status of their authorizations, explain coverage limitations or out-of-pocket responsibilities clearly, and maintain compassionate customer service.
• Compliance & Recordkeeping: Adhere strictly to HIPAA guidelines, payer compliance timelines, and organizational protocols for document handling.

Qualifications & Requirements

• Experience: 2+ years of experience in healthcare intake, patient access, prior authorization, or medical billing/scheduling.
• Insurance Knowledge: In-depth understanding of prior authorization workflows, payer portals (Availity, CoverMyMeds, payer-specific web portals), and medical terminology (ICD-10, CPT, and HCPCS codes).
• Systems Proficiency: Hands-on experience working with EHR/Practice Management platforms (e.g., Epic, Athenahealth, Cerner, or Kareo).
• Skills: Excellent communication and phone etiquette, strong attention to detail, and the ability to multitask in a fast-paced environment.
• Education: High school diploma or equivalent required; associate degree or relevant medical administrative certification preferred.

What We Offer

• Competitive hourly rate /based on experience.
• 401(k) starting January 2026
• Paid time off (PTO) and paid holidays.
• Ongoing training and professional growth opportunities.

About Violet Health

At Violet Health, our mission is to deliver seamless, compassionate, and patient-centered healthcare. We recognize that a patient's care journey begins well before their first clinical encounter. Our Intake & Authorization team serves as the essential gateway, ensuring every patient accesses necessary treatments without administrative delays or unexpected financial burdens.