Prior Authorization & Patient Access Specialist

NorthStar Behavioral Health; Cincinnati (OH); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Competitive salary

Paid time off

403(b) retirement plan

Student loan forgiveness program

Relias training access

Supportive work environment

Purpose-driven work

Employee assistance program

Discount program

Job summary

NorthStar Behavioral Health is seeking a Patient Access and Authorization Specialist to join our team in Cincinnati. You will verify insurance eligibility, determine patient financial responsibility, and obtain necessary authorizations to ensure timely care and minimize financial barriers.

The role requires 3+ years in behavioral healthcare registration, strong knowledge of payer requirements, and proficiency with EHR/practice management systems.

Qualifications

• High school diploma or equivalent; Associate's degree preferred.
• 3+ years in behavioral healthcare registration, access, verification & prior authorization.
• Knowledge of commercial, Medicare, Medicaid & managed care plans.
• Familiarity with CPT, ICD-10 & HCPCS codes.
• Strong attention to detail.
• Experience with EHR & practice management systems.
• Strong organizational, communication & problem-solving skills.
• Ability to manage multiple priorities in a fast-paced healthcare environment.

Responsibilities

• Verify patient insurance eligibility and benefits prior to services.
• Confirm policy effective dates and coverage limits.
• Determine patient financial responsibility (copays, coinsurance, deductibles).
• Obtain and process prior authorizations, precertifications & referrals.
• Gather required clinical documentation from providers.
• Review medical documentation to support authorization requests.
• Communicate with clinical staff and payors about authorization status.
• Monitor approvals and expiration dates; follow up as needed.
• Register patients in the EHR and update demographics/insurance info.
• Educate front desk on insurance requirements and authorization processes.
• Maintain detailed records of authorization activities and payer communications.
• Ensure HIPAA compliance and payer guidelines.
• Assist in reviews/appeals of denials; collaborate with billing.

Skills

Insurance verification

Prior authorizations

EHR systems

Organizational skills

Communication skills

Education

High school diploma or equivalen t

Associate's degree preferred

Tools

EHR software

Practice management systems

Job description

NorthStar Behavioral Health is seeking a Patient Access and Authorization Specialist to join our team in Cincinnati. You will verify insurance eligibility, determine patient financial responsibility, and obtain necessary authorizations to ensure timely care and minimize financial barriers.

The role requires 3+ years in behavioral healthcare registration, strong knowledge of payer requirements, and proficiency with EHR/practice management systems.