Insurance Authorization Representative Associate
Description
At UK King's Daughters, we’re not just a healthcare facility — we’re a family of dedicated professionals who share a passion for making a meaningful difference in the lives of our patients. We’re more than just a place to work; we’re a place to grow, thrive, and contribute to our community.
Job Description :
Job Summary
Responsible for coordinating insurance authorization and pre-certification for scheduled outpatient tests and procedures. Communicates denials and authorization outcomes to relevant parties. Ensures timely and accurate processing of insurance requirements. Collaborates with clinical and administrative teams to support patient access and care continuity. Maintains compliance with organizational and regulatory standards.
Essential Functions
- Tracks, obtains, and extends authorizations from insurance carriers.
- Records and documents insurance information throughout the pre-certification and prior authorization process.
- Maintains and utilizes electronic medical records and relevant databases independently.
- Obtains, interprets, and submits clinical documentation required for prior authorization reviews.
- Escalates unresolved or inadequate authorizations to physicians, service areas, or other departments.
- Communicates authorization status and delays professionally to physicians and clinical staff.
- Follows up on denied authorization requests and facilitates appeals or peer-to-peer reviews.
- Supports claim submission and denial appeal efforts by clarifying authorization details.
- Resolves claim denials related to the prior authorization process through account and claim review.
- Performs other duties as assigned.
Education Requirement
High school diploma or equivalent experience
Experience Requirement
0-2 years of experience in a healthcare, clinical setting, or a relevant area
An equivalent combination of education and experience may be considered.
All experience must be paid and in the same related field.
Part-time and PRN experience will be prorated based on hours worked per week.
Volunteer work and internships for academic credit are not counted.
Certifications & Licensures
N/A
Working Conditions
A. Lifting, pushing, and/or pulling objects up to 50lbs: 2. Occasional ( 50% of the time)
F. Risk of back injury from moving, lifting or positioning patients, equipment, or materials: 1. Never
G. Repetitive motion: 4. Regular (> 50% of the time)
H. Working at heights above 4 feet: 1. Never
I. Working in confined spaces: 1. Never
J. Risk of injuries from use of equipment on the job: 1. Never
K. Job-related travel: 2. Occasional ( Department :
Vascular Lab
Shift :
Day (United States of America)
Time Type :
Full time
Address :
2201 Lexington Avenue
City, State :
Ashland, Kentucky