Prior Authorization & Medical Records Specialist

TriHealth; Cincinnati (OH); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Retirement plans

Tuition reimbursement

Job summary

TriHealth is seeking a Prior Authorization and Medical Records Specialist to secure insurance approvals for PHP, IOP, neuropsychology, and psychiatric medication management. You will liaise with providers, patients, and payers, review chart documentation, and ensure timely authorization before care.

The role also supports documentation and coding tasks in a busy outpatient setting. Ideal candidates will have healthcare credentials, familiarity with EMR, and strong organizational skills to

Qualifications

• Healthcare program degree or certificate completed.
• Equivalent experience accepted in lieu of degree.
• Certified/registered medical assistant with CPR.
• Experience with EMR and medical billing is preferred.

Responsibilities

• Obtain and manage insurance authorizations for behavioral health services.
• Review clinical docs, submit requests, track approvals, and handle denials.
• Maintain accurate records in the electronic medical record system.
• Act as liaison between providers, patients, and payers to ensure timely access.

Skills

Organizational skills

Attention to detail

Strong communication

Decision making

Education

Healthcare program certificate/degree

Equivalent experience accepted

Certified or registered medical assistant (RMA/CAN)

CPR certification

Tools

EMR

Practice management software

Medical coding/billing

Job description

TriHealth is seeking a Prior Authorization and Medical Records Specialist to secure insurance approvals for PHP, IOP, neuropsychology, and psychiatric medication management. You will liaise with providers, patients, and payers, review chart documentation, and ensure timely authorization before care.

The role also supports documentation and coding tasks in a busy outpatient setting. Ideal candidates will have healthcare credentials, familiarity with EMR, and strong organizational skills to