Insurance Authorization Representative Associate

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 (< 10% of the time)

B. Lifting, pushing, and/or pulling objects over 50lbs: 1. Never

C. Standing or walking with objects up to 10lbs: 3. Intermittent (10% - 50% of the time)

D. Standing or walking with objects up to 25lbs: 2. Occasional (< 10% of the time)

E. Sitting at computer workstation for extended periods: 4. Regular (> 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 (< 10% of the time)

L. Loud noises: 1. Never

M. Temperature extremes: 1. Never

N. Hazardous chemicals and fumes including waste: 1. Never

O. Radiation: 1. Never

P. Burns: 1. Never

Q. Cuts/Punctures: 1. Never

R. Bloodborne/airborne pathogens: 1. Never

S. Recombinant DNA or viral vectors: 1. Never

T. Combative/violent people: 1. Never

U. Animal handling (including carcasses): 1. Never

V. Please specify other(s) and amount of exposure (i.e. Occasional, Intermittent or Regular): N/A

Physical Demands

This position requires regular sitting at a computer workstation for extended periods of time; performing tasks with repetitive motions (such as typing); intermittent standing or walking with objects weighing up to 10 pounds; occasional standing or walking with objects weighing up to 25 pounds; and occasional lifting, pushing, and/or pulling of objects weighing up to 50 pounds.

Additional Job Descriptions

N/A

Department:

Vascular Lab

Shift:

Day (United States of America)

Time Type:

Full time

Address:

2201 Lexington Avenue

City, State:

Ashland, Kentucky