Patient Access and Authorization Specialist

The Crossroads Center

Cincinnati (OH)

On-site

USD 23,000 - 29,000

Full time

5 days ago
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Benefits offered by this job

Health insurance
Paid time off (3 weeks)
403(b) Retirement Plan
Student Loan Forgiveness Program
Professional Development
Relias Learning access
Team-oriented environment
Employee Assistance Program

Job summary

NorthStar Behavioral Health is seeking a Patient Access and Authorization Specialist to bridge gaps between patients, clinical teams, and insurance providers. The role centers on verifying eligibility, obtaining prior authorizations, and supporting timely care while minimizing financial barriers.

This full-time position in Cincinnati, OH offers a competitive salary and benefits package within a nonprofit behavioral health setting, emphasizing patient access, accuracy, and compliance with HIPAA

Qualifications

  • High school diploma or equivalent; associate degree preferred.
  • 3+ years in behavioral healthcare registration, access, verification, and prior authorization.
  • Knowledge of commercial, Medicare, and Medicaid plans; familiarity with CPT/ICD-10/HCPCS.

Responsibilities

  • Verify patient insurance eligibility and benefits before scheduled services.
  • Determine patient financial responsibility including copays and deductibles.
  • Obtain and process prior authorizations and referrals.
  • Gather clinical documentation and review it to support authorizations.
  • Communicate with clinical staff and payors regarding status and requirements.
  • Maintain accurate records in the EHR and ensure HIPAA compliance.

Skills

Insurance verification
Prior authorizations
EHR experience
Practice management
Attention to detail
Organization
Communication

Education

High school diploma or equivalent
Associate's degree preferred

Tools

EHR software
Practice management systems

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Patient Access and Authorization Specialist

Full Time Admin Support Cincinnati, OH, US

7 days ago Requisition ID: 1349

Salary Range: $17.00 To $21.00 Hourly

Patient Access and Authorization Specialist

Job Description

NorthStar Behavioral Health is seeking an organized and professional Patient Access and Authorization Specialist to join our team. ThePatient Access and Authorization Specialistplays a key role in the revenue cycle by bridging gaps among patients, clinical teams, and insurance providers. Their primary responsibility is to verify insurance eligibility and secure prior authorizations to ensure patients receive timely care while minimizing unexpected financial barriers.

Who We Are

NorthStar Behavioral Health is a full-service non-profit behavioral healthcare agency. Since 1976, NorthStar Behavioral Healthhas been ensuring access, safety, and quality for our clients in Hamilton County and the Greater Cincinnati area. Every day, we support individuals on their journey to recovery, healing, and hope - and we're just as committed to creating a workplace where our employees can thrive. At NorthStar Behavioral Health, exciting things are happening!We are building our team as we are preparing to move into a new state-of-the-art facility this summer.

What We Offer

  • Competitive Salary and Benefits Package, including health, dental, and employer-paid vision, life, and long-term disability coverages – Employees are eligible the first day of the month after hire!
  • Up to3 weeks of Paid Time Off each year - We value work and life balance!
  • 403(b) Retirement Plan - We help you plan for the future!
  • Student Loan Forgiveness Program– We are a qualifying employer for the Public Service Loan Forgiveness (PSLF) program!
  • Professional Development, CEUs and Learning Access via Relias - We develop our employees!
  • Supportive Work Environment - We lift each other, celebrate wins, and grow strong as a team!
  • Purpose-Driven Work - We make a meaningful impact in our community every day!
  • Employee Assistance Program - Another resource to help you personally!
  • Employee Discount Program - Save on travel, retail, and other services!

What We Require for the Patient Access and Authorization Specialist Role:

Required Qualifications

  • High school diploma or equivalent; Associate's degree preferred.
  • 3+ years of continuous experience in behavioral healthcare registration, patient access, insurance verification, and prior authorization.
  • Knowledge of commercial, Medicare, Medicaid, and managed care insurance plans.
  • Familiarity with medical terminology, CPT, ICD-10, and HCPCS codes.
  • Strong attention to detail.
  • Experience using electronic health records (EHR) and practice management systems.
  • Strong organizational, communication, and problem‑solving skills.
  • Ability to manage multiple priorities in a fast-paced healthcare environment.

Preferred Skills

  • Certified Healthcare Access Associate (CHAA) or similar certification.
  • Experience with revenue cycle management processes.
  • Knowledge of payer authorization requirements and denial management.
  • Strong customer service and patient advocacy skills.
  • Ability to pass a criminal background and drug screen.
  • Current vaccination for tuberculosis (TB) or willingness to be vaccinated upon hire.

Key Job Responsibilities:

  • Verify patient insurance eligibility and benefits before scheduled services.
  • Confirm policy effective dates and coverage limits.
  • Determine patient financial responsibility, including copayments, coinsurance, deductibles, and out‑of‑pocket expenses.
  • Obtain and process prior authorizations, precertification, and referrals from insurance carriers.
  • Gather required clinical documentation from providers.
  • Review medical documentation to support authorization requests.
  • Communicate with clinical staff and insurance representatives regarding authorization status and requirements.
  • Monitor authorization approvals and expiration dates.
  • Track pending authorizations and follow up with payors to ensure timely decisions.
  • Accurately register patients and update demographic and insurance information in the electronic health record (EHR).
  • Educate front desk about insurance requirements, financial responsibilities, and authorization processes.
  • Maintain detailed records of all authorization activities and payer communications.
  • Ensure compliance with HIPAA, payer guidelines, and organizational policies.
  • Review authorization denials and assist in preparing and submitting appeals and reconsideration requests.
  • Collaborate with billing and revenue cycle teams to resolve insurance‑related issues and prevent claim denials related to authorizations.

NorthStar Behavioral Health is an Equal Employment Opportunity (EEO) Employer. Our hiring and employment decisions are made without regard to protected characteristics such as race, color, religion, sex, national origin, age, disability, or genetic information.

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