Precertification Specialist: Prior Auth & Patient Access

UofL Health, Inc.; Louisville (KY); Sur place; USD 42 000 - 54 000; Plein temps

Résumé du poste

UofL Health is seeking a Prec ertification Specialist for the Louisville outpatient services. You will accurately identify medical necessity, submit prior authorization requests, and verify insurance to secure timely financial clearance for procedures and tests.

Responsibilities include coordinating patient encounters across systems, communicating with payers and providers, and maintaining compliant documentation while meeting productivity standards.

Qualifications

• At least one year of patient access, insurance verification, prior authorization, or related experience.
• Three years of prior authorization or related experience preferred.
• Healthcare experience or EHR familiarity is a plus.

Responsabilités

• Accurately identify clinical documentation to support medical necessity for procedures.
• Submit prior authorization and related information to payers in a timely manner.
• Verify patient eligibility and coverage for procedures.
• Coordinate patient encounters across multiple systems and clinics.
• Maintain accurate documentation and ensure HIPAA compliance.
• Assist with denials and appeals when needed.

Connaissances

Patient access

Insurance verification

Prior authorization

Communication skills

HIPAA compliance

Formation

High School Diploma or equivalent

Outils

EHR system

Description du poste

UofL Health is seeking a Prec ertification Specialist for the Louisville outpatient services. You will accurately identify medical necessity, submit prior authorization requests, and verify insurance to secure timely financial clearance for procedures and tests.

Responsibilities include coordinating patient encounters across systems, communicating with payers and providers, and maintaining compliant documentation while meeting productivity standards.