Insurance Authorization Associate – Pre-Cert & Appeals

KDMC Ashland Hospital Corporation; United States; On-site; USD 25,000 - 33,000; Full time

Job summary

UK King's Daughters in Ashland, KY is seeking a detail-oriented Insurance Authorization Coordinator to manage pre-certification for scheduled outpatient tests and procedures. This role communicates denials and authorization outcomes to clinicians, tracks authorizations, and ensures timely processing of insurance requirements.

Collaborating with clinical and administrative teams, the position supports patient access and care continuity while maintaining compliance with organizational and

Qualifications

• Education: High school diploma or equivalent.
• Experience: 0–2 years in healthcare/clinical setting or related field.
• All experience must be paid; part-time/PRN/volunteer experience prorated or not counted.

Responsibilities

• Tracks, obtains, and extends authorizations from insurance carriers.
• Records and documents insurance information throughout the pre-certification and prior authorization process.
• Maintains and utilizes electronic medical records and relevant databases independently.
• Obtains, interprets, and submits clinical documentation required for prior authorization reviews.
• Escalates unresolved or inadequate authorizations to physicians, service areas, or other departments.
• Communicates authorization status and delays professionally to physicians and clinical staff.
• Follows up on denied authorization requests and facilitates appeals or peer-to-peer reviews.
• Supports claim submission and denial appeal efforts by clarifying authorization details.
• Resolves claim denials related to the prior authorization process through account and claim review.
• Performs other duties as assigned.

Job description

UK King's Daughters in Ashland, KY is seeking a detail-oriented Insurance Authorization Coordinator to manage pre-certification for scheduled outpatient tests and procedures. This role communicates denials and authorization outcomes to clinicians, tracks authorizations, and ensures timely processing of insurance requirements.

Collaborating with clinical and administrative teams, the position supports patient access and care continuity while maintaining compliance with organizational and