Prior Authorization

3 days ago

Indianapolis, United States Health & Hospital Corporation of Marion County Full time
Division:Eskenazi Health

Sub-Division: Hospital

Req ID: 22335

Schedule: Full Time

Shift: Days

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis.

FLSA Status

Non-Exempt

Job Role Summary

The Pre-Services Coordinator works directly with patients, referring physician offices, and payers, to ensure full payer clearance prior to receiving care, through pre-registration, financial clearance, authorization, referral validation, and pre-serviceability estimations and collections. The Pre-Services Coordinator establishes the first impression of Eskenazi Health for patients, families, and other external/internal customers, serving as a subject matter expert as it relates to payer requirements, authorizations, appeals and patient navigation.

Essential Functions and Responsibilities

  • Conducts pre-registration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan codes and Coordination of Benefits orders
  • Corrects and updates all necessary data to assure timely, accurate bill submission
  • Maintains accountability for accuracy of data collected and entered into systems and demonstrates the ability to maintain the passing grade on monthly audits
  • Verifies insurance information through payer contacts via telephone, online resources, or electronic verification systems and identifies payer authorization/referral requirements
  • Provides appropriate documentation and follow up to patients, physician offices, case management departments, and payers regarding authorization/referral deficiencies
  • Contacts insurance carriers or other sources to obtain prior authorizations; obtains pre-certification and/or authorization prior to services
  • Identifies all patient financial responsibilities, calculates estimates, collects liabilities, posts payment transactions, and completes waivers as appropriate in the Epic system
  • Identifies self-pay and complex liability calculations and escalates account to Financial Counselors as appropriate
  • Delivers positive patient experience using AIDET
  • Counsels patients regarding insurance benefits by explaining financial responsibilities for services received, payment options, and collections procedures to patients and parties responsible for payment
  • Performs any written and verbal communication necessary to exchange information with designated contacts and promote working relationships with patients, Eskenazi Health leadership and staff, physician offices, and external/internal customers
  • Initiates process for collecting prepays due and performs follow-up to insure maximum collection is achieved
  • Updates and correctly documents in Epic
  • Attains productivity standards, recommending new approaches for enhancing performance and productivity when appropriate
  • Attains quality standards, recommending new approaches for enhancing quality when appropriate
Job Requirements

Accredited Bachelor's degree preferred; OR four (4) years experience in a pre-services setting. High School Diploma or GED required.
  • Certification in Healthcare Business Insights within 60 days of hire
Knowledge, Skills & Abilities
  • Understanding of Medicare regulations, Medicaid MRO, Medicaid Clinic Services, and Commercial insurance related to any necessary prior authorization process/requirements
  • Advanced computer skills to facilitate the utilization of web based applications


Accredited by The Joint Commission and named as one of Indiana's best employers by Forbes magazine for two consecutive years and the top hospital in the state for community benefit by the Lown Institute, Eskenazi Health's programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city's primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana and Sandra Eskenazi Mental Health Center, the first community mental health center in Indiana, just to name a few.

  • Prior Authorization Assistant

    2 weeks ago

    Indianapolis, United States Home Services Unlimited Full time

    Responsible for submitting, tracking, and managing prior authorization. Assists with intake process, verifying insurance, verify orders, scheduling staff and entering related information into computer. Applies for and maintains Prior Auth for Medicaid PA. Assists and maintains Prior Auth for Insurance Clients requiring PA. Updates field staff, Director of...

  • Prior Authorization Expert

    4 days ago

    Indianapolis, Indiana, United States RemX Full time

    ResponsibilitiesThe Prior Authorization Expert will work closely with healthcare providers and insurance companies to secure necessary medications for patients. This field-based position requires traveling to offices around the country, typically 4 days a week, and involves coordinating prior authorizations for specialty drugs.Your primary responsibilities...

  • Prior Authorization

    1 week ago

    Indianapolis, United States Health & Hospital Corporation of Marion County Full time

    Division:Eskenazi Health Sub-Division: Hospital Req ID: 22335 Schedule: Full Time Shift: Days Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of...

  • Field Reimbursement Manager Position

    1 week ago

    Indianapolis, Indiana, United States RemX Full time

    We are looking for a skilled Prior Authorization Specialist to join our team at RemX. As a Field Reimbursement Manager, you will play a crucial role in helping patients access the medication they need by navigating the complex healthcare system.About the JobThis position requires a strong understanding of medical reimbursement and prior authorization...

  • Clinical Access Nurse LPN

    4 weeks ago

    Indianapolis, Indiana, United States Health & Hospital Corporation of Marion County Full time

    About the JobWe are seeking a skilled Clinical Access Nurse LPN to join our team in primary care. This is a full-time position with a competitive salary of $65,000-$80,000 per year, depending on experience.Job SummaryThe Clinical Access Nurse LPN serves as a main point of contact for clinical questions, refill requests, and prior authorizations for patients...

  • Clinical Access Nurse LPN

    4 weeks ago

    Indianapolis, Indiana, United States Health & Hospital Corporation Full time

    About the RoleWe are seeking a Clinical Access Nurse LPN to join our team at Eskenazi Health in Indianapolis, IN.Job SummaryThe Clinical Access Nurse LPN serves as a main source of contact for clinical questions, refill requests, and prior authorizations for patients of the clinic. The ideal candidate will have current Indiana licensure as a Licensed...

  • Medical Access Nurse Professional

    4 weeks ago

    Indianapolis, Indiana, United States Health & Hospital Corporation Full time

    Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County.Salary Range:$65,000 - $85,000 per yearAbout the Job:The Clinical Access Nurse RN serves as a main source of contact for clinical questions/refill requests/Prior Authorizations for patients of the clinic.This individual will participate in both...

  • Clinical Access Nurse RN Specialist

    4 weeks ago

    Indianapolis, Indiana, United States Health & Hospital Corporation Full time

    Job Summary">The Clinical Access Nurse RN Specialist plays a vital role in serving as the main source of contact for clinical questions, refill requests, and prior authorizations for patients of the clinic. This individual will be responsible for participating in both administrative duties and patient care while demonstrating flexibility, adaptability,...

  • Specialty Pharmacy Reimbursement Expert

    5 days ago

    Indianapolis, Indiana, United States RemX Full time

    RemX is seeking a highly skilled Specialty Pharmacy Reimbursement Expert to join our team. This is an excellent opportunity for a professional with expertise in prior authorizations, medical reimbursement, and patient access to specialty drugs.About the JobThis Field Reimbursement Manager position involves visiting provider offices across various territories...

  • Access Department Lead

    1 week ago

    Indianapolis, Indiana, United States Cummins Behavioral Health Systems Full time

    Job SummaryCummins Behavioral Health Systems, Inc. is seeking a highly skilled professional to lead our Access department in Indianapolis, Indiana.The ideal candidate will have a minimum of two years of work experience in medical or behavioral health office and proficiency in Microsoft Word and Excel.We offer a competitive salary of $65,000 per year,...

  • Medical Billing

    2 months ago

    Indianapolis, United States Robert Half Full time

    Job DescriptionJob DescriptionWe are seeking a Part-Time Medical Billing & Coding Specialist based in Indianapolis, Indiana. In this role, you will be working with insurance companies and other payers, handling all aspects of the billing process. This includes eligibility and benefit verifications, referrals, prior authorizations, claim submissions, appeals,...

  • Revenue Cycle Specialist

    4 weeks ago

    Indianapolis, United States LHH Recruitment Solutions Full time

    Job DescriptionJob DescriptionJob Title: Revenue Cycle Specialist (Remote)MUST BE LOCAL TO INDIANALocation: Remote - Indianapolis, IN Duration: 3 - 6 months (with potential for extension)Start Date: Flexible (1 - 2 weeks)Work Hours: 8:00 AM - 4:00 PM, Monday - FridayCompensation: $16/hourTraining: 6 weeks remote, including HIPAA compliance and safety...

  • Revenue Cycle Specialist

    4 weeks ago

    Indianapolis, United States LHH Recruitment Solutions Full time

    Job DescriptionJob DescriptionJob Title: Revenue Cycle Specialist Location: Indianapolis, IN - 46219 Duration: 3 - 6 months (with potential for extension)Start Date: Flexible (1 - 2 weeks)Work Hours: 8:00 AM - 4:00 PM, Monday - FridayCompensation: $16/hourTraining: 6 weeks, including HIPAA compliance and safety trainingTop Skills Required:Insurance...

  • Reimbursement Specialist

    4 weeks ago

    Indianapolis, Indiana, United States RemX Full time

    Job OverviewWe are seeking a Reimbursement Specialist to join our team in a travel territory position. As a key member of our team, you will work closely with healthcare providers and insurance companies to ensure seamless reimbursement processes.This role involves visiting provider offices throughout your designated territory, fostering strong...

  • Clinical Access Nurse RN

    2 months ago

    Indianapolis, United States Health & Hospital Corporation Full time

    Division:Eskenazi Health Sub-Division: Hospital Req ID: 21699 Schedule: Full Time Shift: Days Salary Range: Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both...

  • Medical Professional for Dermatology Care

    4 weeks ago

    Indianapolis, Indiana, United States OptumCare Full time

    At American Health Network, we strive to deliver exceptional patient care and are seeking a skilled Medical Assistant to join our team. This is an exciting opportunity to work in a dynamic environment with a focus on delivering high-quality healthcare services.Job SummaryWe are looking for a highly motivated and detail-oriented Medical Assistant to support...

  • Pharmacy Claim Examiner

    3 days ago

    Indianapolis, United States Innovative Rx Us Holdings Inc Full time

    ResponsibilitiesBilling and Claims Processing: Verify patient eligibility, process claims, and resolve billing errors.Customer Service: Provide exceptional customer service to patients and respond to their billing inquiries.Third-Party Communication: Communicate with third-party payors to resolve denied claims and obtain prior authorizations.The estimated...

  • CLINICAL ACCESS NURSE LPN

    3 weeks ago

    Indianapolis, United States Eskenazi Health Full time

    Division:Eskenazi Health Sub-Division: Hospital Req ID: 21987 Schedule: Full Time Shift: Days Salary Range: Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities...

  • CLINICAL ACCESS NURSE LPN

    3 weeks ago

    Indianapolis, United States Eskenazi Health Full time

    Division:Eskenazi Health Sub-Division: Hospital Req ID: 21987 Schedule: Full Time Shift: Days Salary Range: Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities...

  • Ambulatory Care Specialist

    4 weeks ago

    Indianapolis, United States Community Health Network Full time

    Job Summary">The Ambulatory Triage Registered Nurse is a critical member of the Family Medicine Care team at Community Health Network. As a hybrid RN, you will work onsite in our 96th Street office and remotely from home, conducting phone triage, patient education, scheduling appointments, prior authorizations, prescription refill, referrals, care...