Medical Authorization Specialist

4 days ago


Louisville, Kentucky, United States SENTA Partners Full time
Precertification Coordinator Job Description

Senta Partners is seeking a detail-oriented and organized Precertification Coordinator to join our team. As a key member of our healthcare team, you will be responsible for ensuring timely and accurate precertification and authorization of medical procedures, surgeries, and tests.

Key Responsibilities:
  • Authorization Management:
    • Obtain and verify precertifications or referrals for medical procedures, surgeries, and tests as required by insurance providers.
    • Collaborate with physicians, nurses, and other clinical staff to gather necessary clinical information for precertification requests.
    • Track and monitor pending authorizations and reauthorizations.
  • Communication:
    • Serve as a liaison between the medical staff, billing department, and insurance companies.
    • Communicate with insurance providers to ensure timely submission and approval of requests.
    • Notify clinical staff and patients of any issues or denials.
  • Documentation:
    • Maintain detailed records of all communications and authorization documents.
    • Update patient files with relevant preauthorization information.
    • Ensure accurate entry of authorization details into electronic health records or other tracking systems.
  • Billing Support:
    • Assist the billing department in resolving claim denials related to lack of authorization.
    • Provide necessary documentation or clinical information to support appeals when necessary.
  • Regulatory Compliance:
    • Stay updated with changes in insurance policies and governmental regulations pertaining to preauthorization.
    • Ensure processes and procedures are compliant with regulations and industry best practices.
  • Continuous Improvement:
    • Monitor and analyze precertification process efficiency and recommend changes for improvement.
    • Participate in training and professional development activities.

Qualifications:

  • High school diploma required; Associate's or Bachelor's degree in a related field preferred.
  • Experience in medical billing, insurance, or a related field.
  • Familiarity with medical terminology.
  • Strong organizational skills and attention to detail.
  • Excellent communication skills, both verbal and written.
  • Proficiency with electronic health record systems and office software.


  • Louisville, Kentucky, United States SpringHealth Behavioral Health and Integrated Care Full time

    About the RoleWe are seeking a highly organized and detail-oriented Authorization Specialist to join our team at SpringHealth Behavioral Health and Integrated Care. As an Authorization Specialist, you will play a critical role in ensuring that our patients receive the necessary authorizations for their treatment.Key ResponsibilitiesAnswering Phones and...


  • Louisville, Kentucky, United States EBlu Solutions LLC Full time

    Job Title: Prior Authorization SpecialistWe are seeking a highly skilled Prior Authorization Specialist to join our team at EBlu Solutions LLC. As a Prior Authorization Specialist, you will play a critical role in ensuring that prior authorizations are completed accurately and in a timely manner.Job Summary:The Prior Authorization Specialist will be...


  • Louisville, Kentucky, United States Family Allergy & Asthma Full time

    Job DescriptionPosition OverviewThe Authorization Management Specialist plays a crucial role in ensuring the smooth operation of prior authorization processes within the organization. This position requires a comprehensive understanding of job responsibilities and functions, working under the guidance of management. The specialist will engage with various...


  • Louisville, Kentucky, United States UofL Health Full time

    About the RoleWe are seeking a highly skilled Precertification Specialist to join our team at UofL Health. As a key member of our healthcare team, you will play a critical role in ensuring a positive patient experience by accurately and efficiently completing all necessary steps related to prior authorization, medical necessity determination, and financial...


  • Louisville, Kentucky, United States BrightSpring Health Services Full time

    PHARMACY AUTHORIZATION SPECIALISTCompany OverviewBrightSpring Health Services is dedicated to providing exceptional healthcare solutions tailored to the needs of our clients. We operate in a non-retail pharmacy environment, focusing on the pharmaceutical requirements of long-term care and senior living facilities. Our organization is experiencing significant...


  • Louisville, Kentucky, United States Medasource Full time

    Position OverviewRole: Prior Authorization SpecialistContract Type: 6 Month Contract-to-Hire (Onsite)Location: Louisville, KYEssential Qualifications:High School Diploma or equivalent is mandatory.Proficient in computer skills, with a typing speed of at least 30 words per minute and 95% accuracy.Minimum of one year experience in patient access is...


  • Louisville, Kentucky, United States SpringHealth Behavioral Health and Integrated Care Full time

    Clinical Authorization Specialist **Job Summary** We are seeking a highly organized and detail-oriented Clinical Authorization Specialist to join our team at SpringHealth Behavioral Health and Integrated Care. As a Clinical Authorization Specialist, you will play a critical role in ensuring that patients receive the necessary authorizations for...


  • Louisville, Kentucky, United States SpringHealth Behavioral Health and Integrated Care Full time

    {"title": "Authorization Specialist", "description": "Job SummaryWe are seeking a highly organized and detail-oriented Authorization Specialist to join our team at SpringHealth Behavioral Health and Integrated Care. As an Authorization Specialist, you will play a critical role in ensuring that our patients receive the necessary authorizations for their...


  • Louisville, Kentucky, United States Family Allergy & Asthma Full time

    Position Overview:Family Allergy & Asthma is seeking a meticulous Medication Authorization Coordinator to join our dedicated team. This role is essential in ensuring the smooth operation of medication management processes.Key Responsibilities:- Collaborate closely with specialty pharmacies and healthcare providers to streamline the tracking and management of...


  • Louisville, Kentucky, United States TEKsystems Full time

    Job SummaryWe are seeking a highly skilled Prior Authorization Specialist to join our team at TEKsystems. As a Prior Authorization Specialist, you will play a critical role in ensuring that our clients receive the necessary authorizations for their services.Key ResponsibilitiesVerify insurance eligibility and benefits of prospects/referrals and determine LHC...


  • Louisville, Kentucky, United States Southern Home Care Services, Inc. Full time

    About the RoleWe are seeking a skilled Prior Authorization Coordinator to join our team at Southern Home Care Services, Inc. This role is responsible for ensuring timely and accurate completion of client prior authorization and change of therapy paperwork.Key ResponsibilitiesCollaborate with prescribers and facility contacts to ensure accurate and timely...


  • Louisville, Kentucky, United States Medasource Full time

    Job OverviewPosition: Prior Authorization SpecialistEmployment Type: 6 Month Contract-to-Hire (Onsite)Location: Louisville, KYKey Qualifications:High School Diploma or equivalent is mandatory.Proficient in computer skills, with a typing speed of at least 30 words per minute and 95% accuracy.A minimum of one year in patient access roles is...


  • Louisville, Kentucky, United States BrightSpring Health Services Full time

    Job Title: Prior Authorization CoordinatorWe are seeking a highly skilled Prior Authorization Coordinator to join our team at Pharmacy Alternatives, a specialized pharmacy provider focused on serving individuals with cognitive, intellectual, and developmental disabilities (I/DD). As a Prior Authorization Coordinator, you will play a critical role in ensuring...


  • Louisville, Kentucky, United States BrightSpring Health Services Full time

    About the RoleWe are seeking a skilled Pharmacy Prior Authorization Coordinator to join our team at BrightSpring Health Services. As a Pharmacy Prior Authorization Coordinator, you will play a critical role in ensuring the timely and accurate completion of prior authorization and change of therapy paperwork for our clients.Key ResponsibilitiesCollaborate...


  • Louisville, Kentucky, United States Medasource Full time

    Position OverviewRole: Authorization SpecialistEmployment Type: Contract-to-HireLocation: RemoteKey Qualifications:High School Diploma or equivalent is mandatory.Proficient in computer skills, with a typing speed of at least 30 words per minute and 95% accuracy.Minimum of one year experience in patient access is preferred.Familiarity with medical terminology...


  • Louisville, Kentucky, United States Norton Healthcare Full time

    Job SummaryWe are seeking a highly skilled Medical Assistant/X-Ray Specialist to join our team at Norton Healthcare. As a Medical Assistant/X-Ray Specialist, you will play a vital role in providing exceptional patient care and supporting our medical team in a fast-paced clinical environment.Key ResponsibilitiesPerform administrative and clinical duties under...


  • Louisville, Kentucky, United States Baptist Health Full time

    Job SummaryWe are seeking a highly skilled Medical Assistant/Limited Medical Radiology Specialist to join our team at Baptist Health. As a key member of our healthcare team, you will play a vital role in providing exceptional patient care and support.Key ResponsibilitiesCollect and record patient information, including medical histories and vital...


  • Louisville, Kentucky, United States Norton Medical Group Full time

    About the PositionWe are seeking a highly skilled Head and Neck Medical Oncologist to join our team at Norton Medical Group. As a board-certified or board-eligible medical oncologist, you will have the opportunity to practice primarily in head and neck oncology and work with a multidisciplinary team of specialists.The selected candidate will have the chance...


  • Louisville, Kentucky, United States UofL Health Full time

    About UofL HealthUofL Health is a fully integrated regional academic health system with a mission to deliver patient-centered care to each and every patient. Our team of highly skilled healthcare professionals is dedicated to providing compassionate and expert care to patients of all ages and stages of life.Precertification Specialist RoleWe are seeking a...


  • Louisville, Kentucky, United States Concentra Career Choice Full time

    Job SummaryWe are seeking a highly skilled Medical Support Specialist to join our team at Concentra Career Choice. As a Medical Support Specialist, you will play a vital role in providing exceptional patient care and supporting our clinical team.Key ResponsibilitiesPerform routine medical and testing procedures under direct supervision of the treating...