Prior Authorization Specialist

HCA Healthcare; Olathe (KS); On-site; USD 40,000 - 56,000; Full time

Benefits offered by this job

Health benefits

401(k) match

Tuition assistance

Paid time off

Life insurance

Flexible spending accounts

Job summary

HCA Healthcare is seeking an Authorization Coordinator to manage prior authorizations, medical information gathering, and communication with insurance providers. The role supports timely appointments and claims processing within a hospital setting.

The position requires at least a high school diploma, with preferred experience in medical insurance verification. Strong customer service and teamwork are essential as you collaborate with referral coordinators and clinical staff.

Qualifications

• Prior Authorization experience is preferred.
• One year of related experience with medical insurance plans and/or Medicare benefits verification is required.
• One year medical clinic, urgent care, or hospital care setting experience preferred.

Responsibilities

• Review and complete prior authorizations to ensure timeliness of appointments, testing, procedures, and claims filing.
• Obtain clinical information needed to complete prior authorizations, including medical history, diagnosis, and lab reports.
• Follow payor criteria and submit requests timely; document in the billing system and related Health Information Systems.
• Track status of prior authorizations via payer portals and inform stakeholders of updates.
• Review denied claims for clinical accuracy and resubmit with corrections as needed.
• Provide patient-centered communication and excellent customer service.
• Communicate with insurance companies to pre-certify/authorize/amend services.
• Suggest policy/process improvements to increase efficiency and service quality.
• Identify and resolve issues by coordinating with relevant parties.
• Ensure documentation is entered in standard formats across systems.
• Research Patient Visit History to ensure payor-specific payment window compliance and guide patients on steps.

Skills

Prior Authorization

Medical insurance experience

Customer service

Education

High School Diploma or GED

Job description

HCA Healthcare is seeking an Authorization Coordinator to manage prior authorizations, medical information gathering, and communication with insurance providers. The role supports timely appointments and claims processing within a hospital setting.

The position requires at least a high school diploma, with preferred experience in medical insurance verification. Strong customer service and teamwork are essential as you collaborate with referral coordinators and clinical staff.