Prior Authorization Specialist - Patient Access & Finance

UofL Health; Louisville (KY); On-site; USD 42,000 - 64,000; Full time

Job summary

UofL Health is seeking a Precertification Specialist to support surgical procedures and diagnostic services by handling prior authorizations, medical necessity determinations, and financial clearances across clinics and hospitals in Louisville.

You will gather clinical documentation, submit requests to payers, verify eligibility, coordinate with physicians and staff, and ensure accurate records and timely responses while upholding HIPAA and departmental policies.

Qualifications

• High school diploma or equivalent required.
• Minimum 1 year of patient access, insurance verification, or prior authorization experience.
• Medical terminology knowledge preferred.

Responsibilities

• Identify documents to support medical necessity for procedures and orders.
• Submit authorizations and clinical information to payers in a timely manner.
• Assess orders to determine patient class and coordinate with physicians.
• Contact plans to determine eligibility and coverage for procedures.
• Coordinate patient encounters across registration and clinical systems.
• Document all findings and communications in the patient record.
• Maintain compliance with HIPAA and organizational policies.
• Act as liaison between patient, payer, provider, and staff.

Skills

Patient access

Insurance verification

Prior authorization

Medical terminology

Education

High School Diploma

Tools

Electronic Health Record (EHR)

Job description

UofL Health is seeking a Precertification Specialist to support surgical procedures and diagnostic services by handling prior authorizations, medical necessity determinations, and financial clearances across clinics and hospitals in Louisville.

You will gather clinical documentation, submit requests to payers, verify eligibility, coordinate with physicians and staff, and ensure accurate records and timely responses while upholding HIPAA and departmental policies.