Prior Authorization Specialist I, Hospital Admissions, Full-Time

Position Highlights: Position: Prior Authorization Location: Hospital Admissions 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). 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: Medical, dental, vision insurance Life Insurance Free Parking Paid time off Education assistance 403(b) with employer matching Wellness Program Additional benefits based on employment status Additional Information: Relocation: Must relocate to Grand Junction, CO 81505 before starting work. Work Location: In-person/onsite Application Deadline: Posting will remain open until August 31, 2026