Pre-Authorization Specialist - Fast Payer Approvals

Universal Hospital Services Inc.; Westcliff (SC); On-site; USD 42,000 - 65,000; Full time

Job summary

Aiken Regional Medical Centers, part of Universal Health Services, is seeking a Pre-Authorization Specialist in Aiken, South Carolina. You will identify required authorizations, verify coverage, and document results in CERNER to ensure timely approvals for scheduled services.

You will communicate with physicians and offices, facilitate peer-to-peer reviews when needed, and initiate appeals for denied authorizations to protect patient access and facility reimbursement.

Qualifications

• Associate degree in business or equivalent experience.
• Five years of healthcare facility experience preferred.
• Medical terminology knowledge preferred.
• Ability to communicate detailed information clearly.

Responsibilities

• Identify payer requirements and obtain prior authorizations for scheduled procedures.
• Communicate authorization status with physician offices and assist with peer-to-peer reviews as needed.
• Initiate appeals for denied authorizations prior to service to avoid denials and penalties.
• Understand insurance processing requirements and payer timelines to secure timely authorizations.

Skills

Healthcare experience

Medical terminology

CHAA certification

Communication skills

Cerner system

Education

Associate degree in business

Tools

Cerner

Job description

Aiken Regional Medical Centers, part of Universal Health Services, is seeking a Pre-Authorization Specialist in Aiken, South Carolina. You will identify required authorizations, verify coverage, and document results in CERNER to ensure timely approvals for scheduled services.

You will communicate with physicians and offices, facilitate peer-to-peer reviews when needed, and initiate appeals for denied authorizations to protect patient access and facility reimbursement.