Prior Authorization Specialist I, Hospital Admissions, PRN/Pool

**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 June 30, 2026