Patient Access & Authorization Specialist

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

Job summary

Pioneers Medical Center is seeking a Revenue Cycle professional to obtain pre-authorizations for imaging and review patient insurance details. You will communicate financial responsibilities to patients by phone or mail and coordinate with clinical staff to gather required documents for timely pre-authorization.

The role requires knowledge of medical billing codes and strict HIPAA adherence, with cross-training in hospital/clinic registration and discharge processes as needed.

Qualifications

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

Responsibilities

• Obtain pre-authorizations for imaging.
• Review insurance eligibility, deductibles, coinsurance, and copays.
• Inform patients of financial responsibility by phone or mail.
• Coordinate with clinical team to gather pre-authorization documents.
• Submit requests via insurance portal, fax, or phone.
• Communicate denials to appropriate provider or department.

Skills

Communication

HIPAA compliance

Organizational skills

Problem solving

Calm under pressure

Teamwork

Confidentiality

Emotional intelligence

Education

High school diploma or equivalent

Revenue Cycle courses

Medicare Fraud and Abuse Education

AAHAM or HFMA CRCR certification desired within 2 years

Current BLS certification

Knowledge of ICD-10/CPT/HCPCS codes

Tools

Athena/Meditech Authorization Management

Job description

Pioneers Medical Center is seeking a Revenue Cycle professional to obtain pre-authorizations for imaging and review patient insurance details. You will communicate financial responsibilities to patients by phone or mail and coordinate with clinical staff to gather required documents for timely pre-authorization.

The role requires knowledge of medical billing codes and strict HIPAA adherence, with cross-training in hospital/clinic registration and discharge processes as needed.