Prior Authorization Specialist: Streamline Patient Access

Sullivan County Community Hospital; Benefiel Corner (IN); On-site; USD 38,000 - 52,000; Full time

Job summary

Sullivan County Community Hospital is seeking a Prior Authorization Representative to join the clerical team in Sullivan, IN. The role supports patient access workflows, verifies payer coverage, and manages authorization queues with accuracy and timeliness.

The ideal candidate has at least one year of related experience, strong medical terminology knowledge, and proficiency with Meditech and MS Excel. Collaborative, organized, and adaptable candidates will thrive in this environment.

Qualifications

• High school diploma or equivalent required.
• One year of patient access, medical billing, or prior authorization experience.
• Solid knowledge of medical terminology and CPT/HCPCS/ICD-10 coding.
• Proficiency with Meditech and Excel; able to collaborate across departments.

Responsibilities

• Verify insurance eligibility and benefits with payers or payer websites prior to authorization.
• Document payer policies and procedures for coverage and prior approval requirements.
• Ensure Medicare diagnosis support and frequency guidelines are not exceeded.
• Manage daily work queues to submit authorizations timely and accurately.
• Notify ordering physician and patient of authorization outcomes.
• Follow up with payers on status of prior authorizations.
• Identify denial trends with Revenue Cycle leadership and suggest process improvements.
• Implement payer-specific checklists for eligibility, benefits, and authorization.

Skills

Patient access

Medical billing

Prior authorization

Medical terminology

CPT/HCPCS/ICD-10 coding

Meditech

MS Excel

Collaboration across teams

Time management

Adaptability

Education

High school diploma or equivalent

Tools

Meditech

MS Excel

Job description

Sullivan County Community Hospital is seeking a Prior Authorization Representative to join the clerical team in Sullivan, IN. The role supports patient access workflows, verifies payer coverage, and manages authorization queues with accuracy and timeliness.

The ideal candidate has at least one year of related experience, strong medical terminology knowledge, and proficiency with Meditech and MS Excel. Collaborative, organized, and adaptable candidates will thrive in this environment.