Prior Authorization Specialist I, Hospital Admission, Full-Time

Prior Authorization Specialist I, Hospital Admission, Full-Time Job Category: Administrative Requisition Number: PRIOR003918 Full-Time On-site Locations Showing 1 location Main Campus Community Hospital 2351 G Road Grand Junction, CO 81501, USA 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. 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 June 30, 2026 Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr