Description:
Who We’re Looking For
We are seeking a detail-oriented, patient-focused Patient Access, Verification & Authorization Specialist to serve as a critical point of contact in the client journey. This role blends patient access, insurance verification, and prior authorization responsibilities to ensure a seamless, supportive, and financially transparent experience for clients entering care.
The ideal candidate brings payer knowledge, exceptional communication skills, and the ability to work collaboratively with clinical and administrative teams in a fast-paced behavioral health environment.
What You’ll Be Doing
Insurance Verification & Authorizations
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Ensure accurate demographic, insurance, and financial information is verified at the time of arrival.
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Verify insurance coverage and benefits to confirm service eligibility and determine financial responsibility.
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Spend significant time communicating with insurance carriers to confirm benefits, service limits, and authorization requirements.
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Navigate multiple payer portals (e.g., Availity, Navinet, ePromise, Pear) to verify benefits, submit authorization requests, upload clinical documentation, and track approval status.
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Obtain, manage, and monitor prior authorizations, ensuring accurate CPT codes, units, service lines, and timely renewals to prevent disruptions in care.
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Track authorization visit counts, expiration dates, and follow-up requirements.
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Maintain detailed documentation of all payer interactions within the electronic health record (EHR).
Coordination & Collaboration
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Collaborate closely with clinical staff and leadership to obtain required clinical documentation for authorization requests.
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Partner with billing and operations teams to resolve insurance, registration, or authorization issues efficiently.
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Support smooth patient flow by proactively addressing coverage or access barriers.
Compliance & Documentation
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Maintain strict confidentiality of client information in compliance with HIPAA and organizational policies.
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Ensure all documentation is complete, accurate, and timely within the EHR system.
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Follow organizational policies related to collections, authorizations, and financial communication.
Requirements:
Requirements
Required Skills & Qualifications
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High school diploma or equivalent; additional training in healthcare administration is a plus.
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Experience in a medical office, hospital, or customer service environment preferred.
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Strong communication and interpersonal skills.
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Proficiency with EHR systems and basic computer applications.
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Ability to multitask, prioritize, and remain calm under pressure.
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Knowledge of insurance plans, authorizations, and medical terminology is helpful
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Strong written and verbal communication skills.
Core Competencies
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Customer service excellence
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Accuracy and attention to detail
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Problem-solving and critical thinking
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Professionalism and empathy
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Team collaboration
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Confidentiality and compliance awareness
Work Schedule
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12:30 PM- 9:00 PM Monday - Friday
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Train in our Allentown, PA office for 4-6 weeks. Milage reimbursed for travel.
Benefits
We offer a competitive salary and comprehensive benefits package, including:
Paid Time Off
Paid Holidays
Medical, Dental, Life, and Long-Term Disability Insurance
401(k) Plan
