Patient Access & Authorization Specialist

Eye Center Of Northern Colorado • Fort Collins, CO

305d • $22 - $26

About The Position

The Patient Access & Authorization Specialist plays a dual role in facilitating timely clinical care and supporting financial transparency for patients. This position combines prior authorization expertise, referral coordination, financial counseling, and clinical liaison functions to ensure seamless access to treatment while minimizing care delays and financial burdens. The role requires close coordination with providers, patients, and payers and serves as a key resource for both Revenue Cycle and clinic operations.

Requirements

• Deep understanding of patient financial assistance programs, including 340B, manufacturer co-pay programs, and step therapy regulations.
• Experience in healthcare billing, revenue cycle processes, and insurance verification.
• Ability to work effectively with clinical teams, billing specialists, and insurance providers to resolve barriers to care.
• Proficient in electronic health records (EHR) and practice management (EPM) systems; experience with NextGen is a plus.
• Exceptional interpersonal skills with the ability to deliver empathetic, accurate, and professional financial counseling and support.
• High school diploma or GED.
• Minimum of 3 years' experience in healthcare patient access, financial counseling, or prior authorization roles.
• Word processing/computer scheduling experience.
• Knowledge of typical office work environment.

Responsibilities

• Perform advance chart reviews to validate treatment protocols and ensure alignment with payer requirements and step therapy guidelines.
• Verify and confirm that all scheduled procedures, diagnostic tests, and specialty services meet clinical and insurance criteria prior to the date of service.
• Confirm the need for and obtain prior authorizations based on payer rules, submitting accurate and complete documentation.
• Track authorization status and follow through with payers to ensure timely approvals.
• Communicate authorization and referral outcomes to patients, providers, and scheduling teams to ensure coordinated care.
• Confirm and collect any necessary referrals in accordance with insurance plan requirements to avoid care disruptions or claim denials.
• Conduct pre-visit confirmation calls to verify insurance, explain patient financial responsibilities, and confirm that all authorizations and referrals are in place.
• Provide patients with clear expectations regarding co-pays, deductibles, and any required documentation prior to services being rendered.
• Review patient insurance coverage to determine eligibility and out-of-pocket responsibilities.
• Educate and advocate for patients regarding financial resources including co-pay assistance, manufacturer programs, 340B drug pricing, and step therapy requirements.
• Provide structured payment plan options when appropriate and assist patients with accessing digital co-pay assistance platforms.
• Support patients in understanding the long-term financial implications of their care plans.
• Act as the primary liaison between clinic teams and Revenue Cycle Management (RCM) for any changes to treatment plans that affect authorization or payer requirements.
• Coordinate updates to prior authorizations and step therapy documentation when treatment regimens are adjusted.
• Ensure financial implications of treatment changes are communicated to patients and internal teams to avoid care delays or claim issues.
• Partner closely with clinical staff, physicians, front office, and billing departments to ensure continuity of care and a seamless patient experience.
• Maintain detailed documentation in the EHR/PM system regarding chart reviews, authorizations, referrals, and patient financial discussions.

Benefits

• PTO Accruals Start at 3 Weeks
• Comprehensive Medical and Dental Insurance
• Company Paid Optical Allowance
• Company Paid Routine Eye Care
• Short-Term and Long-Term Disability Insurances
• Educational Allowance
• Generous Paid Holiday Program
• 401K With Company Match

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED