Associate Patient Access Rep- Prior Authorizations

Join Community

Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, “community” is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered — and we couldn’t do it without you.

Make a Difference

The Prior Authorization team member is responsible for obtaining and managing insurance authorization for medical services, procedures, and medications. This role ensures timely approvals, minimizes delays in patient care, and supports revenue cycle efficiency through accurate and compliant processing of authorization requests.

Exceptional Skills and Qualifications

• Two years of experience in customer service or healthcare office setting preferred.
• High School Diploma or GED required.
• Prior Authorization or Patient Access experience preferred.
• Experience with specialty services (radiology, surgery, infusion, etc.) preferred.
• Familiarity with Epic or other healthcare systems preferred.
• Initiate and submit prior authorization requests to insurance companies for services, procedures, and medications.
• Review provider orders and documentation to ensure medical necessity and completeness.
• Verify insurance benefits and authorization requirements.
• Communicate with payers, providers, and clinical staff to obtain required information.
• Track authorization status and follow up to ensure timely approvals.
• Document authorization details accurately in the system.
• Resolve denials or incomplete requests by obtaining additional documentation or appealing when appropriate.
• Maintain knowledge of payer policies and authorization guidelines.
• Collaborate with scheduling, registration, and clinical teams to prevent delays in care.
• Ensure compliance with organizational policies and regulatory requirements.