Top 125 Authorization representative Jobs in Louisville, Ky

System Director, Authorization Management & Pre-Service
Norton Healthcare —Louisville, KY
- Full-time
- Background check
- Nursing
- RN License
- Paid parental leave
- Paid holidays
Healthcare Call Center Representative Scheduler
Baptist Health System KY & IN —Louisville, KY
- Full-time
- Remote
- Background check
- Computer literacy
- Medical office experience
- Paid training
4d
Prior Authorization Specialist
Ohio Valley Pain Institute —Louisville, KY
- $20 - $22 an hour
- Part-time
- Medical office experience
- HIPAA
- Mid-level
- Health savings account
- Health insurance
Quick Apply
Pre-Service Representative, Norton Medical Group Training and Access, Shift Times Vary
Norton Healthcare —Louisville, KY
- Full-time
- High school diploma or GED
- Pediatrics
- EMR systems
Lead Pre-Service Representative, Authorization Management, Days
Norton Healthcare —Louisville, KY
- Full-time
- Mid-level
- Team management
- 1 year
10d
Medicare D Billing Representative
PharMerica —Louisville, KY
- Full-time
- Remote
- Research
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
10h
Admissions Assistant
Valhalla Post Acute —Louisville, KY
- Full-time
- Organizational skills
- Communication skills
- Marketing
Quick Apply
1d
Health Plan Member Services Analyst
Abilis Health Plan —Louisville, KY
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Health insurance
- Prescription drug insurance
PRECERTIFICATION SPECIALIST
FIRST UROLOGY P S C —Jeffersonville, IN
- Full-time
- Background check
- Customer service
- Pass drug screening
- AD&D insurance
- Paid holidays
Quick Apply
3d
Logistics Specialist - Hybrid
Bakelite —Louisville, KY
- Extended hours
- Hybrid work
- 18 years or older
- 5 years
- Pass drug screening
Quick Apply
14d
Account Executive
Energy Systems Group —Louisville, KY
- Full-time
- Remote
- Travel
- Senior level
- Communication skills
- Paid holidays
- Health insurance
SEASONAL Soap Maker / Retail Associate Part time
Buff City Soap Franchise —Louisville, KY
- Part-time
- Ability to walk for extended periods
- Computer literacy
- Ability to lift 50 pounds
- 401(k) matching
- Employee discount
Quick Apply
11d
Overnight Closer Part Time
Planet Fitness - Glow Brands —Louisville, KY
- $15 - $16 an hour
- Part-time
- 18 years or older
- Computer literacy
- High school diploma or GED
- 401(k) matching
- Employee discount
Quick Apply
Principal Coronary Cathworks Territory Manager - Louisville, KY
Medtronic —Louisville, KY
- $85,000 a year
- Full-time
- 6 years
- Up to 50% travel
- Hospital
- Health savings account
- Employee stock purchase plan
Member Services Representative Part Time
Planet Fitness - Glow Brands —Louisville, KY
- $12.50 - $13.00 an hour
- Part-time
- Computer literacy
- High school diploma or GED
- US work authorization
- 401(k) matching
- Employee discount
Quick Apply
NSO Apprentice Interest
Disabled American Veterans —Louisville, KY
- $20.18 - $31.39 an hour
- Full-time
- Customer service
- Office
- High school diploma or GED
- On-the-job training
Quick Apply
Soap Maker / Retail Associate Part time
Buff City Soap Franchise —Louisville, KY
- $12 an hour
- Part-time
- Ability to walk for extended periods
- Computer literacy
- Ability to lift 50 pounds
- 401(k) matching
- Employee discount
Quick Apply
Patient Care Coordinator
FUNctional Therapy —Louisville, KY
- Full-time
- Private practice
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
3d
Member Services Representative
Crunch Fitness - Fitness Ventures LLC —Louisville, KY
- $10 an hour
- Part-time
- 18 years or older
- CPR Certification
- High school diploma or GED
- Employee discount
- Gym membership
Quick Apply
Mailroom Associate- In Office Louisville KY
Firstsource Healthcare —Louisville, KY
- $16 an hour
- Overtime
- Customer service
- Computer literacy
- Pass drug screening
- Opportunities for advancement
2d

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System Director, Authorization Management & Pre-Service

Norton Healthcare -
Louisville, KY

Apply Now

Job Details

Full-time

Benefits

Paid parental leave
Paid holidays
Health insurance
Dental insurance
401(k)
Parental leave
Vision insurance
403(b)

Qualifications

Bachelor's degree

Full Job Description

Location: Louisville, Kentucky
Job Category: Executive Leadership
Job ID: 156825
Facility Group: Norton System Services

Job Description

Responsibilities

The System Director Authorization Management & Pre-Service leads and manages a team composed primarily of denial nurses, utilization review nurses (RN, LPN), pre-service and insurance verification representatives. This team develops processes for prospective, concurrent and retrospective utilization review. They provide timely notification of admission to third party payors and managed care companies. The team works closely with the hospital-based care managers and clinical offices to provide clinically accurate, timely and meaningful clinical reviews to payors in order to obtain authorizations. The System Director Authorization Management & Pre-Service collaborates with staff external to the organization (payors), as well as members of the Norton Healthcare team (Patient Financial Services, Registration, Norton Medical Group, Health Information Management, and Care Management). As a key leader in Norton Healthcare's Improvement Network, the System Director Authorization Management & Pre-Service, will coach and facilitate this team in performance improvement initiatives, to ensure high quality outcomes and exceptional patient care. Tracking, trending and reporting key financials (lost revenue due to denials) is required. The System Director Authorization Management & Pre-Service provides guidance to staff on preventing and appealing denials and educates on medical necessity criteria such as InterQual and/or Milliman Care Guidelines. This position also leads and develops processes for securing outpatient authorizations. The team works closely with clinic offices and provides and obtains accurate, timely authorizations from payors.

Key Accountabilities:

Assists staff to ensure proper hospital &payor authorization requirements are met. Maintains current organized databases regarding payor requirements, reviews, contacts, decisions and appeals. Is knowledgeable of managed care contracts, government payment methodologies and coverage guidelines.
Provides annual performance evaluations for direct reports & provides feedback to other system leaders as requested. Evaluates annual employee engagement results and works with teams to establish action plans to ensure workforce concerns are being addressed. Mentors & coaches team as needed to ensure that members have the right tools and training to deliver on expected goals and quality patient care.
Identifies and coordinates improvement opportunities and leads formal groups to identify processes to reduce insurance denials/loss of revenue. Continually assesses the insurance authorization process for opportunities to streamline and eliminates duplication of work. Collaborates with staff & leaders in other departments (both external and internal to NHC). Provides appropriate feedback to the staff as needed regarding payor guideline changes.
Responsible for achieving annual department performance metrics developed by system leadership, and the management of financial resources to meet and exceed the expected budget (efficient utilization review).
Demonstrates critical thinking, problem solving and prioritization skills. Uses positive communication techniques, is skilled in empathizing, listening and supporting while maintaining strict professional boundaries. Manages the department by leading as a role model. The leader holds themselves accountable to the same performance expectations as those reporting to them.

Qualifications

Required:

Five (5) years of management experience in care management & care coordination setting and/or clinical experience.
Bachelor Degree
Registered Nurse

Desired:

Master Degree
Certified Case Manager OR Certified Professional in Denial & Appeal Management

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Screening requirements:

Background check
License & education verification
Employment reference verification
Drug Screen

Norton Healthcare offers a competitive benefit package, including:

Paid vacation, sick days and holidays
Paid parental leave
403b/401k retirement plan
View more: Benefits Guide
Medical, Dental, and Vision Insurance

Discover meaningful career opportunities at NortonHealthcareCareers.com.
Norton Healthcare Careers - Together, We Will.

Norton Healthcare is a leader in serving adult and pediatric patients from throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. The not-for-profit hospital and health care system is Louisville's second largest employer, with more than 20,000 employees.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Norton Healthcare strives to make the Norton Healthcare Careers site accessible to all job seekers. If you're a candidate with a disability, we will make reasonable efforts to accommodate your needs during the application process.

If you have a disability and need to request a reasonable accommodation, email [email protected]

Equal Employment Opportunity is the law.

PI175ded73b288-25404-40657801

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Refine Your Search

authorization representative jobs in louisville, ky

System Director, Authorization Management & Pre-Service

Healthcare Call Center Representative Scheduler

Prior Authorization Specialist

Pre-Service Representative, Norton Medical Group Training and Access, Shift Times Vary

Lead Pre-Service Representative, Authorization Management, Days

Medicare D Billing Representative

Admissions Assistant

Health Plan Member Services Analyst

PRECERTIFICATION SPECIALIST

Logistics Specialist - Hybrid

Account Executive

SEASONAL Soap Maker / Retail Associate Part time

Overnight Closer Part Time

Principal Coronary Cathworks Territory Manager - Louisville, KY

Member Services Representative Part Time

NSO Apprentice Interest

Soap Maker / Retail Associate Part time

Patient Care Coordinator

Member Services Representative

Mailroom Associate- In Office Louisville KY

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