Prior Authorization Specialist: Patient Access Pro

Memorial Physician Practices; Northern (KY); Hybrid; USD 42,000 - 56,000; Full time

Benefits offered by this job

Comprehensive Benefits

Financial Protection & PTO

Education tuition assistance

Loan assistance

401(k) retirement package

Job summary

UP Health System - Portage is seeking a Prior Authorization Specialist to obtain preauthorizations, coordinate with care teams, and ensure compliant documentation for insurance approvals. You will work with physicians, patients and payers to secure timely authorizations and maintain accurate records.

The role emphasizes accuracy, communication and knowledge of payer guidelines, with opportunities for professional growth and comprehensive benefits in a hospital setting.

Qualifications

• Education: High School Diploma or Equivalent Required
• Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.

Responsibilities

• Contacts insurers to obtain pre-certifications and authorization.
• Follows up with offices, counselors, patients and payers to complete pre-certification.
• Coordinates with staff to resolve issues and appeal denials.
• Ensures data complies with Medicare/Medicaid and payer requirements.
• Educates patients and providers on referral and authorization rules.
• Notifies patients of coverage status and preauthorization updates.
• Maintains referrals and insurance information in the system.

Education

High School Diploma or Equivalent

Job description

UP Health System - Portage is seeking a Prior Authorization Specialist to obtain preauthorizations, coordinate with care teams, and ensure compliant documentation for insurance approvals. You will work with physicians, patients and payers to secure timely authorizations and maintain accurate records.

The role emphasizes accuracy, communication and knowledge of payer guidelines, with opportunities for professional growth and comprehensive benefits in a hospital setting.