Authorization Specialist

Position Overview

We are seeking a proactive, highly organized Patient Intake & Prior Authorization Specialist to manage the front-end patient onboarding and coverage approval process. In this dual-focus role, you will verify patient eligibility, register incoming referrals, secure insurance prior authorizations, and coordinate directly with clinical teams and third-party payers.

Key Responsibilities

• Intake & Registration: Accurately collect and enter demographic, clinical, and insurance information for new and returning patients into the Electronic Health Record (EHR) system.
• Insurance Verification: Verify active coverage, copayments, coinsurance, deductibles, and network status across commercial plans, Medicare, and Medicaid.
• Prior Authorization Management: Prepare, submit, and track prior authorization requests for specialist consultations, procedures, diagnostic tests, and pharmaceuticals according to payer-specific criteria.
• Clinical Coordination: Collaborate with physicians, nurses, and medical assistants to obtain necessary clinical documentation, chart notes, and letters of medical necessity.
• Denial Resolution & Peer-to-Peer Support: Monitor pending authorization requests, identify root causes for initial coverage denials, assist in drafting appeals, and schedule peer-to-peer clinical reviews when needed.
• Patient Communication: Keep patients informed regarding the status of their authorizations, explain coverage limitations or out-of-pocket responsibilities clearly, and maintain compassionate customer service.
• Compliance & Recordkeeping: Adhere strictly to HIPAA guidelines, payer compliance timelines, and organizational protocols for document handling.

Qualifications & Requirements

• Experience: 2+ years of experience in healthcare intake, patient access, prior authorization, or medical billing/scheduling.
• Insurance Knowledge: In-depth understanding of prior authorization workflows, payer portals (Availity, CoverMyMeds, payer-specific web portals), and medical terminology (ICD-10, CPT, and HCPCS codes).
• Systems Proficiency: Hands-on experience working with EHR/Practice Management platforms (e.g., Epic, Athenahealth, Cerner, or Kareo).
• Skills: Excellent communication and phone etiquette, strong attention to detail, and the ability to multitask in a fast-paced environment.
• Education: High school diploma or equivalent required; associate degree or relevant medical administrative certification preferred.

What We Offer

• Competitive hourly rate /based on experience.
• Comprehensive medical, dental, and vision benefits.
• 401(k) starting January 2026
• Paid time off (PTO) and paid holidays.
• Ongoing training and professional growth opportunities.

About Violet Health

At Violet Health, our mission is to deliver seamless, compassionate, and patient-centered healthcare. We recognize that a patient's care journey begins well before their first clinical encounter. Our Intake & Authorization team serves as the essential gateway, ensuring every patient accesses necessary treatments without administrative delays or unexpected financial burdens.