Patient Access & Prior Authorization Specialist

Urology Centers of Alabama; Homewood (IL); On-site; USD 52,000 - 68,000; Full time

Job summary

The Insurance Verification & Authorization Specialist at Urology Centers of Alabama is responsible for verifying patient insurance coverage and benefits and securing all required prior authorizations before scheduled appointments and procedures. This role supports timely reimbursement, minimizes denials, and maintains compliant front-end revenue cycle operations.

Responsibilities include verifying eligibility, confirming coverage details, initiating authorizations, tracking requests, following

Qualifications

• High school diploma or equivalent; associate degree or healthcare cert preferred.
• 3-5 years in insurance verification, prior authorization, medical billing or patient access.
• Knowledge of payer requirements across HMO, PPO, Medicare, Medicaid.
• Familiarity with CPT/ICD-10 coding related to medical necessity and authorization.
• Experience with EHR/practice management systems.
• Strong attention to detail, follow-up discipline, and organization.
• Excellent communication for patients, payers, and internal teams.

Responsibilities

• Verify insurance eligibility and benefits for scheduled patients via payer portals, clearinghouses, and calls.
• Confirm coverage details including copays, deductibles, coinsurance, and authorization requirements.
• Identify prior authorization requirements for urology procedures and initiate requests.
• Submit and track prior authorization requests to ensure timely turnaround before service dates.
• Follow up on pending authorizations, escalate delays, and resolve denials or requests for docs.
• Document verification and authorization status in the EHR/practice management system.
• Communicate coverage gaps or denial risk to scheduling, clinical, and billing staff.
• Calculate and communicate estimated patient out-of-pocket costs for procedures.
• Maintain knowledge of payer medical necessity criteria (Medicare, Medicaid, Commercial).

Skills

Attention to detail

Follow-up discipline

Excellent communication

Organizational skills

Education

High school diploma or equivalent

Associate degree or healthcare-related certification

Tools

Payer portals

EHR / Practice Management Systems

Job description

The Insurance Verification & Authorization Specialist at Urology Centers of Alabama is responsible for verifying patient insurance coverage and benefits and securing all required prior authorizations before scheduled appointments and procedures. This role supports timely reimbursement, minimizes denials, and maintains compliant front-end revenue cycle operations.

Responsibilities include verifying eligibility, confirming coverage details, initiating authorizations, tracking requests, following