Prior Authorization Specialist - Patient Access

University Medical Center; Louisville (KY); Presencial; USD 22.000 - 30.000; Jornada completa

Descripción de la vacante

University Medical Center is seeking a Patient Access & Authorization specialist to accurately identify and document clinical information to support medical necessity for procedures and medication orders.

The role submits authorizations, verifies coverage, and collaborates with physicians and payers to resolve eligibility questions while ensuring accurate records and HIPAA-compliant communication.

Formación

• High school diploma or equivalent required.
• At least one year of patient access, insurance verification, prior authorization, or related experience required.
• Three years of prior authorization or related experience preferred.
• Medical terminology knowledge preferred.

Responsabilidades

• Identify and document clinical information to support medical necessity for procedures and medication orders.
• Submit authorizations and information to payer in a timely manner per plan rules.
• Assess orders to determine patient class and clarify with physicians as needed.
• Contact plan/payers to determine eligibility and coverage information.
• Coordinate patient encounters using multiple systems and applications.
• Document findings accurately in the patient record and maintain timely communication.
• Maintain productivity and meet daily assignment targets.
• Ensure accurate authorization details in referrals to produce clean payer transactions.
• Stay compliant with policies, HIPAA, and regulatory requirements.
• Assist in prioritizing work per department and patient needs.

Conocimientos

Patient access

Insurance verification

Prior authorization

Communication

Educación

High School Diploma or equivalent

Herramientas

Electronic Health Record (EHR)

Descripción del empleo

University Medical Center is seeking a Patient Access & Authorization specialist to accurately identify and document clinical information to support medical necessity for procedures and medication orders.

The role submits authorizations, verifies coverage, and collaborates with physicians and payers to resolve eligibility questions while ensuring accurate records and HIPAA-compliant communication.