Patient Access and Authorization Specialist

Patient Access and Authorization Specialist Job Description

North Star Behavioral Health is seeking an organized and professional Patient Access and Authorization Specialist to join our team. The
Patient Access and Authorization Specialist
plays a key role in the revenue cycle by bridging gaps among patients, clinical teams, and insurance providers. Their primary responsibility is to verify insurance eligibility and secure prior authorizations to ensure patients receive timely care while minimizing unexpected financial barriers.

North Star Behavioral Health is a full-service non-profit behavioral healthcare agency. Since 1976,
North Star Behavioral Health
has been ensuring access, safety, and quality for our clients in Hamilton County and the Greater Cincinnati area. Every day, we support individuals on their journey to recovery, healing, and hope - and we're just as committed to creating a workplace where our employees can thrive. At North Star Behavioral Health, exciting things are happening!We are building our team as we are preparing to move into a new state-of-the-art facility this summer.

• Competitive Salary and Benefits Package
  , including health, dental, and employer-paid vision, life, and long-term disability coverages – Employees are eligible the first day of the month after hire!
• Up to3 weeks of Paid Time Off each year
  - We value work and life balance!
• 403(b) Retirement Plan - We help you plan for the future!
• Student Loan Forgiveness Program
  – We are a qualifying employer for the Public Service Loan Forgiveness (PSLF) program!
• Professional Development, CEUs and Learning Access via Relias
  - We develop our employees!
• Supportive Work Environment
  - We lift each other, celebrate wins, and grow strong as a team!
• Purpose-Driven Work
  - We make a meaningful impact in our community every day!
• Employee Assistance Program
  - Another resource to help you personally!
• Employee Discount Program
  - Save on travel, retail, and other services!

• High school diploma or equivalent;
  Associate's degree preferred.
• 3+ years of continuous experience in behavioral healthcare registration, patient access, insurance verification, and prior authorization.
• Knowledge of commercial, Medicare, Medicaid, and managed care insurance plans.
• Familiarity with medical terminology, CPT, ICD-10, and HCPCS codes.
• Strong attention to detail.
• Experience using electronic health records (EHR) and practice management systems.
• Strong organizational, communication, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced healthcare environment.

• Certified Healthcare Access Associate (CHAA) or similar certification.
• Experience with revenue cycle management processes.
• Knowledge of payer authorization requirements and denial management.
• Strong customer service and patient advocacy skills.
• Ability to pass a criminal background and drug screen.
• Current vaccination for tuberculosis (TB) or willingness to be vaccinated upon hire.

• Verify patient insurance eligibility and benefits before scheduled services.
• Confirm policy effective dates and coverage limits.
• Determine patient financial responsibility, including copayments, coinsurance, deductibles, and out-of-pocket expenses.
• Obtain and process prior authorizations, precertification, and referrals from insurance carriers.
• Gather required clinical documentation from providers.
• Review medical documentation to support authorization requests.
• Communicate with clinical staff and insurance representatives regarding authorization status and requirements.
• Monitor authorization approvals and expiration dates.
• Track pending authorizations and follow up…