Prior Authorization & Patient Access Specialist

Community Health Network; Indianapolis (IN); On-site; USD 38,000 - 55,000; Full time

Job summary

Community Health Network in Indiana seeks a Prior Authorization team member to obtain and manage insurance approvals for medical services, procedures and medications. You will collaborate with payers, providers and clinical staff to ensure timely approvals and accurate documentation.

You will review orders, verify benefits, track status and resolve denials, while maintaining compliance with policy and regulatory requirements to support efficient patient care and hospital revenue cycle.

Qualifications

• Minimum 2 years in customer service or healthcare office setting.
• Experience with prior authorization and medical documentation is a plus.
• Familiarity with Epic or similar health IT systems.

Responsibilities

• Obtain and submit prior authorization requests to payers.
• Review provider orders for medical necessity and completeness.
• Verify insurance benefits and authorization requirements.
• Communicate with payers, providers and clinical staff to obtain required information.
• Track authorization status and follow up to ensure timely approvals.
• Document authorization details accurately in the system.
• Resolve denials or incomplete requests by obtaining additional documentation.

Skills

Customer service

Healthcare office experience

Prior Authorization experience

Communication skills

Education

High School Diploma or GED

Tools

Epic Systems

Job description

Community Health Network in Indiana seeks a Prior Authorization team member to obtain and manage insurance approvals for medical services, procedures and medications. You will collaborate with payers, providers and clinical staff to ensure timely approvals and accurate documentation.

You will review orders, verify benefits, track status and resolve denials, while maintaining compliance with policy and regulatory requirements to support efficient patient care and hospital revenue cycle.