Patient Access & Authorization Specialist

Description

Who We Are:

At Panorama Eyecare, we are not just a team; we are a community of dedicated professionals united in our quest to provide the best eyecare anywhere. Our unflinching commitment to excellence and our core values make us an Employer of Choice. Join us in shaping the future of eyecare as we thrive together!

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.

Major Responsibilities:

Advance Chart Review (“Chart Prep”) & Pre-Visit Service Confirmation

• 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.

Pre-Visit Patient Outreach

• 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.

Patient Financial Advocacy

• 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.

Clinic & RCM Liaison for Treatment Plan Changes

• 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.

Team Collaboration

• 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.

Requirements

Who You Are:

• Expert-Level Knowledge: Deep understanding of patient financial assistance programs, including 340B, manufacturer co-pay programs, and step therapy regulations.
• Revenue Cycle & Insurance Expertise: Experience in healthcare billing, revenue cycle processes, and insurance verification.
• Collaboration & Problem-Solving: Ability to work effectively with clinical teams, billing specialists, and insurance providers to resolve barriers to care.
• Technical Proficiency: Proficient in electronic health records (EHR) and practice management (EPM) systems; experience with NextGen is a plus.
• Customer Service Excellence: Exceptional interpersonal skills with the ability to deliver empathetic, accurate, and professional financial counseling and support.

Education/Certifications/Experience:

• 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.

Physical Demands:

• Ability to sit for long periods of time with frequent stooping and stretching.
• Ability to lift up to 25 pounds.
• Requires eye-hand coordination and manual dexterity.
• Ability to raise hands and arms to shoulder level without restriction, pain, or discomfort.
• Ability to perform extended use of phones and computer keyboarding without pain or discomfort.

Additional Job Details

• This is a Full-Time position located at Denver Eye Surgeons, 13772 Denver West Parkway, Building 55, Ste 100, Lakewood, CO 80401
• Compensation for this role will be $23 - $27 an hour based on related experience/certification.

Our Growth Opportunities

At Panorama Eyecare, we care about our employee’s ability to grow within the company. Therefore, we have created career growth plans that allow employees the ability to work toward their professional growth. We encourage all employees to apply for internal openings they may be qualified for, and we welcome the opportunity to interview and coach employees on how to grow.

Our Employee Perks

• 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

Join Our Team!

Embark on a rewarding journey with Panorama Eyecare and become part of a team that embodies the values of Partnership, Engagement, Excellence, and Stewardship. As an Eyecare Professional, you will not only provide exceptional patient care, but also shape the future of our practices. Together, we are transforming the eyecare landscape. Click "apply" now and let your passion for excellence and patient well-being shine! This position will be posted for 30 days or until the position is filled.

EEOC:

Panorama Eyecare is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any characteristic protected by law.

Salary : $23 - $27