Job Description:
- Position:Prior Authorization Specialist I
- Schedule:Monday - Friday
- Application Deadline: Open until October 31 2025 or until filled
Responsibilities:
- Gather Patient Information: Collect and review patient medical records diagnosis codes and procedure details to support the pre-authorization request.
- Verify Insurance Coverage: Confirm patient information and insurance coverage through verifying photo ID insurance cards and personal information.
- Submit Pre-Authorization Requests: Prepare and submit pre-authorization requests to insurance companies adhering to their specific procedures and requirements.
- Follow Up: Monitor the progress of pre-authorization requests and follow up with insurance providers to expedite the approval process.
- Communicate with Healthcare Providers: Collaborate with healthcare providers to obtain any necessary documentation notes or additional information required for pre-authorization.
- Patient Education: Explain the pre-authorization process to patients including potential out-of-pocket costs and address any questions or concerns they may have.
- Document and Recordkeeping: Maintain detailed records of pre-authorization requests approvals denials and communications with insurance companies and healthcare providers.
- Compliance: Ensure that all pre-authorization processes comply with relevant laws and regulations including HIPAA (Health Insurance Portability and Accountability Act).
- Appeals: If a pre-authorization request is denied assist in the appeals process by providing necessary documentation and information to support the appeal
Requirements:
High school diploma or equivalent.
Knowledge of medical terminology preferred.
Compensation:
- $19.00 - $21.85 per hour depending on education and experience.
- Discretionary bonuses relocation expenses merit increase market adjustments recognition bonuses and other forms of discretionary compensation may be available.
Benefits: (FT/PT)
- Medical dental vision insurance.
- Paid time off.
- Education assistance.
- 403(b) with employer matching.
- Additional benefits based on employment status.
Additional Information:
- Job Type: Full-Time
- Benefits: 403(b) 403(b) matching dental insurance health insurance life insurance
- paid time off vision insurance.
- Relocation: Must relocate to Grand Junction CO 81505.
- Work Location: In-person/onsite
Required Experience:
IC