Patient Access: Verification & Authorization Specialist

Job Description

Job DescriptionDescription:

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

• Ensure accurate demographic, insurance, and financial information is verified at the time of arrival.
• Verify insurance coverage and benefits to confirm service eligibility and determine financial responsibility.
• Spend significant time communicating with insurance carriers to confirm benefits, service limits, and authorization requirements.
• Navigate multiple payer portals (e.g., Availity, Navinet, ePromise, Pear) to verify benefits, submit authorization requests, upload clinical documentation, and track approval status.
• Obtain, manage, and monitor prior authorizations, ensuring accurate CPT codes, units, service lines, and timely renewals to prevent disruptions in care.
• Track authorization visit counts, expiration dates, and follow-up requirements.
• Maintain detailed documentation of all payer interactions within the electronic health record (EHR).
• Assist patient in Medicaid application process.

Coordination & Collaboration

• Collaborate closely with clinical staff and leadership to obtain required clinical documentation for authorization requests.
• Partner with billing and operations teams to resolve insurance, registration, or authorization issues efficiently.
• Support smooth patient flow by proactively addressing coverage or access barriers.

Compliance & Documentation

• Maintain strict confidentiality of client information in compliance with HIPAA and organizational policies.
• Ensure all documentation is complete, accurate, and timely within the EHR system.
• Follow organizational policies related to collections, authorizations, and financial communication.

Requirements:

Requirements

Required Skills & Qualifications

• High school diploma or equivalent; additional training in healthcare administration is a plus.
• Experience in a medical office, hospital, or customer service environment preferred.
• Strong communication and interpersonal skills.
• Proficiency with EHR systems and basic computer applications.
• Ability to multitask, prioritize, and remain calm under pressure.
• Knowledge of insurance plans, authorizations, and medical terminology is helpful
• Strong written and verbal communication skills.

Core Competencies

• Customer service excellence
• Accuracy and attention to detail
• Problem-solving and critical thinking
• Professionalism and empathy
• Team collaboration
• Confidentiality and compliance awareness

Work Schedule

• 11:30 AM- 8:00 PM Monday - Friday
• 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