Patient Access & Authorization Specialist

Frederick Health; Frederick (MD); On-site; USD 42,000 - 56,000; Full time

Job summary

Frederick Health is seeking a Referral and Authorization Specialist for Practice Support. The role focuses on patient insurance referrals, authorizations for in-house services, eligibility verification, and price estimations to ensure prior to ambulatory care.

Under supervision, you will support registration, scheduling, and no-surprise act compliance while delivering frontline customer service to patients and clinical staff alike.

Qualifications

• High school diploma or GED required; some college coursework preferred.
• Healthcare revenue cycle experience and authorization expertise are highly valued.
• Knowledge of CPT/ICD-10 codes and medical terminology is preferred.
• Proficiency with NextGen, Meditech, and Office tools; HIPAA compliance essential.

Responsibilities

• Complete pre-determination and authorization processes prior to services.
• Verify insurance eligibility, benefits, and price estimations per payer guidelines.
• Obtain referrals and physician approvals as required by insurers.
• Maintain knowledge of payer requirements and utilization of online eligibility systems.
• Provide premier customer service to internal and external customers.

Skills

Attention to detail

Time management

HIPAA compliance

Communication skills

Teamwork

Microsoft Office / NextGen / Meditech

Education

High school diploma or GED

Some college coursework

Tools

NextGen

Meditech

Meditech Expanse

Microsoft Word/Outlook/Excel

Job description

Frederick Health is seeking a Referral and Authorization Specialist for Practice Support. The role focuses on patient insurance referrals, authorizations for in-house services, eligibility verification, and price estimations to ensure prior to ambulatory care.

Under supervision, you will support registration, scheduling, and no-surprise act compliance while delivering frontline customer service to patients and clinical staff alike.