Patient Access & Authorization Specialist

Pioneers Medical Center; Colorado; On-site; USD 26,000 - 32,000; Full time

Job summary

Pioneers Medical Center in Colorado is seeking an experienced Revenue Cycle Specialist to manage pre-authorizations for imaging, review insurance eligibility, and inform patients of financial responsibilities. The role collaborates with clinical staff and uses the Athena/Meditech Authorization Management tool.

This full-time, hourly position requires a high school diploma, knowledge of billing codes (ICD-10, CPT, HCPCS), and HIPAA compliance.

Qualifications

• High school diploma or equivalent required.
• Revenue Cycle courses and continuing education as provided.
• Annual Medicare Fraud and Abuse Education.
• Medicare Secondary Payer documentation.
• Certification as a Revenue Cycle Specialist through AAHAM or HFMA desired within two years of employment.
• Current BLS required within six months.
• Knowledge of medical billing practices, including ICD-10, CPT, and HCPCS codes.

Responsibilities

• Obtains pre-authorizations for imaging.
• Reviews information regarding insurance eligibility, deductibles, coinsurance, and/or copays for patients.
• Informs patients of their financial responsibility either via phone or mail.
• Works closely with clinical team to obtain various clinical documents to complete the pre-authorization process.
• Submits requests via insurance portal, fax, or phone.
• Communicates denials to appropriate provider or department.
• Completes requests accurately and timely to ensure quality patient care.
• Maintains HIPAA compliance and confidentiality.

Skills

Communication skills

Professional demeanor

Organizational skills

HIPAA compliance

Problem-solving

Emotional intelligence

Education

High school diploma or equivalent

Revenue Cycle courses

Medicare Fraud & Abuse Education

Medicare Secondary Payer documentation

AAHAM or HFMA certification within 2 years

Current BLS within 6 months

Medical billing knowledge: ICD-10, CPT, HCPCS

Job description

Pioneers Medical Center in Colorado is seeking an experienced Revenue Cycle Specialist to manage pre-authorizations for imaging, review insurance eligibility, and inform patients of financial responsibilities. The role collaborates with clinical staff and uses the Athena/Meditech Authorization Management tool.

This full-time, hourly position requires a high school diploma, knowledge of billing codes (ICD-10, CPT, HCPCS), and HIPAA compliance.