Precertification Specialist: Prior Auth & Patient Access

UofL Health; Louisville (KY); On-site; USD 36,000 - 60,000; Full time

Job summary

UofL Health is seeking a Precertification Specialist to support prior authorization, medical necessity determinations, and financial clearance across clinics and hospital services in Louisville. The role requires identifying medical documentation, submitting authorizations to payers, verifying eligibility, and maintaining accurate patient records to ensure a smooth patient experience.

With a background in patient access or insurance verification and knowledge of medical terminology, you will

Qualifications

• At least one year of patient access, insurance verification, prior authorization, or related experience.
• Three years of prior authorization or related experience preferred.
• Medical Terminology knowledge is preferred.

Responsibilities

• Identify clinical documentation to support medical necessity for procedures and orders.
• Submit authorizations and clinical information to payers in a timely manner.
• Assess orders to determine patient class and clarify with physicians.
• Coordinate patient verifications using registration and eligibility systems.
• Maintain accurate documentation in patient records and referrals.
• Respond to payer inquiries and ensure compliant, timely processing.

Education

High School Diploma or equivalent

Job description

UofL Health is seeking a Precertification Specialist to support prior authorization, medical necessity determinations, and financial clearance across clinics and hospital services in Louisville. The role requires identifying medical documentation, submitting authorizations to payers, verifying eligibility, and maintaining accurate patient records to ensure a smooth patient experience.

With a background in patient access or insurance verification and knowledge of medical terminology, you will