Patient Access & Authorization Specialist

Pioneers Medical Center; Meeker (CO); On-site; USD 27,000 - 32,000; Full time

Job summary

Pioneers Medical Center in Meeker, CO is seeking a Revenue Cycle Specialist to manage pre-authorizations for imaging and verify insurance eligibility. You will inform patients of financial responsibilities and submit requests through various channels, ensuring accuracy and privacy.

The role requires HIPAA awareness, strong communication, and teamwork. Cross-training in registration and discharge is included; occasional pre-certifications may be needed.

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 certification as CRCR within two years.
• Current BLS required within six months.
• Knowledge of medical billing practices, including ICD-10, CPT, and HCPCS codes desired.

Responsibilities

• Obtains pre-authorizations for imaging.
• Reviews insurance eligibility, deductibles, coinsurance, and copays.
• Informs patients of financial responsibility by phone or mail.
• Submits requests via insurance portal, fax, or phone.
• Communicates denials to provider or department.
• Maintains HIPAA confidentiality and compliance.
• Cross-trains in hospital/clinic registration and discharge.
• Assists with pre-certification for hospital admits.
• Participates in educational activities, staff meetings, and in-services as required

Skills

Communication skills

Customer service

Organizational skills

Professional demeanor

HIPAA compliance

Problem solving

Emotional intelligence

Education

High school diploma

Revenue Cycle courses

BLS certification within 6 months

AAHAM or HFMA certification within 2 years

Tools

Athena/Meditech Authorization Management

Job description

Pioneers Medical Center in Meeker, CO is seeking a Revenue Cycle Specialist to manage pre-authorizations for imaging and verify insurance eligibility. You will inform patients of financial responsibilities and submit requests through various channels, ensuring accuracy and privacy.

The role requires HIPAA awareness, strong communication, and teamwork. Cross-training in registration and discharge is included; occasional pre-certifications may be needed.