Prior Authorization Pro: Healthcare Payer Liaison

Navajo Health Foundation - Sage Memorial Hospital, Inc.; Ganado (AZ); On-site; USD 48,000 - 60,000; Full time

Job summary

Navajo Health Foundation - Sage Memorial Hospital, Inc. seeks an organized Prior Authorization Specialist to verify insurance, secure authorizations, and ensure medical necessity for services at Sage Memorial Hospital.

You will work with providers, coders, HIM, and payers to obtain documentation and approvals, ensuring compliant, timely reimbursements. Responsibilities include demographic verification, payer communication, documentation, and assisting with appeals when needed.

Qualifications

• High School Diploma or GED required.
• 1–2 years in clerical support, patient registration, or insurance verification in a hospital/medical setting.
• Knowledge of HIPAA and confidentiality requirements.
• Bilingual in English and Navajo preferred; strong communication skills in both languages.

Responsibilities

• Verify demographics and insurance coverage.
• Obtain prior authorizations for inpatient and outpatient services.
• Coordinate with coders for coding clarifications for authorization.
• Document approvals and status in required systems.
• Follow up with payers on authorization progress and denials.
• Assist Admissions & Registration as needed.
• Maintain productivity logs and meet daily deadlines.

Skills

Bilingual English Navajo

Communication skills

Multitasking

Professionalism

Education

High School Diploma or GED

Tools

MEDITECH Expanse

Job description

Navajo Health Foundation - Sage Memorial Hospital, Inc. seeks an organized Prior Authorization Specialist to verify insurance, secure authorizations, and ensure medical necessity for services at Sage Memorial Hospital.

You will work with providers, coders, HIM, and payers to obtain documentation and approvals, ensuring compliant, timely reimbursements. Responsibilities include demographic verification, payer communication, documentation, and assisting with appeals when needed.