Prior Authorization Specialist (FT)

Family-Health-West; Fruita (CO); On-site; USD 22,000 - 32,000; Full time

Benefits offered by this job

Employee Assistance Program

Health plan options

Dental

Vision

Life Insurance

Disability Insurance

Job summary

Family Health West in Fruita, CO is seeking a detail-oriented team member for our Prior Authorization/Administrative support role. You will handle calls from physicians, patients, and offices, obtain authorizations, and maintain accurate patient records in the EHR.

The role emphasizes strong customer service, organization, and collaboration with multiple departments to support efficient care delivery in western Colorado.

Qualifications

• Two (2) years of experience in the medical field.
• Minimum of one (1) year experience working with insurance companies.
• Proficiency with Excel and reporting tools.

Responsibilities

• Answer phone calls from physician offices, hospitals, and patients with strong customer service.
• Maintain accurate patient information and confidentiality.
• Obtain prior authorizations by contacting insurance providers.
• Update EHR with prior authorization numbers and insurance details.
• Work with Coordinator/Manager to improve workflow and procedures.

Skills

Customer service

Communication

Time management

Organizational skills

Problem solving

Education

High School diploma or higher

Tools

Excel

EHR

Job description

FHW Support Serv Bld
237 N. Plum Street
Fruita, CO 81521, USA

FHW Support Serv Bld
237 N. Plum Street
Fruita, CO 81521, USA

You belong here! At Family Health West, you’re more than an employee, you’re family.

When you enter our facility, you know it’s Family Health West because, well, the color speaks for itself. You’ll be part of a team that strives to bring color to care in a vibrant environment by creating fun, effective treatment programs helping to empower and inspire our patients while providing the tools and care they need to achieve their wellness goals.

When we say you’ll do what you love, we mean it! Welcomed by open arms and warm smiles, you’ll join a team that encourages professional growth. We are sure to put on our listening ears when you share new ideas and approaches to care because that’s what got us to the top! You’ll wear your badge proudly, knowing that you contribute each day, to providing care that is unmatched, in western Colorado.

About Family Health West

Our roots go deep— founded by the community in 1946, it’s no wonder our hospital feels like coming home. We were built from the ground up with the hands of our own community, a labor of dedication and hope by our people, for our people, for the future.

At Family Health West we go beyond what corporate hospitals deliver, we’ve created a culture of prosperity where warmth, passion, and care flourishes. As we focus on continually improving outcomes for patients, our network of healthcare providers includes a 25-bed critical access hospital, one of the largest rehab providers in western Colorado, outpatient surgical services, specialty clinics, emergency services, skilled nursing, and assisted living facilities.

Nestled at the base of the Colorado National Monument, Family Health West has an outdoor paradise at your back door. The community culture is fitting for outdoor lovers, bikers, hikers, or those just simply soaking in the panoramic views.

Essential Functions

• Answer phone calls from physician offices, hospitals, and patients using exceptional customer service skills in a timely and efficient manner.
• Reliable and punctual attendance is essential; expected to be at job as scheduled each scheduled day.
• Communicate necessary information to others as appropriate.
• Request any necessary documentation/information from outside providers to complete prior authorizations.
• Obtain prior authorization by calling patients insurance company, assisting patients with questions and offering assistance.
• Develop strong organizational structure, workflow and operating procedures for department under the directing of the Coordinator/Manager.
• Update EHR with prior authorization numbers, insurance information and any other relevant information.
• Participate in department workshops & training.
• Establish effective rapport with other employees, patients, physicians, vendors, etc.
• Work collaboratively with other departments.
• Follow all standard operating procedures.
• Knowledge of Medical service lines in Hospital Services &/or Physician Services.
• Other job related duties as assigned.

General Duties

• Accurately enter patient information into computer in a timely and efficient manner.
• Obtain authorization within a timely and efficient manner.
• Scan all documentation into patient electronic chart in a timely and efficient manner.
• Maintain patient confidentiality at all times.
• Possess working use of Excel & reporting tools as required for Prior Authorization.
• Communicate with understanding, patience, respectfulness & kindness to help to promote a positive atmosphere.
• Utilize problem solving skills.
• General Office Equipment: computer, telephone, keyboard, scanner, mouse, etc.

Opening Info

Position will be open until filled

The wage for this position starts at $19.65 and goes up based on experience

Benefits

• FHW offers a full benefits package including:
• FOR ALL EMPLOYEES:
• Employee Assistance Program
• 403 (B) with 4% match from FHW and zero day vesting schedule
• FOR FULL TIME EMPLOYEES WORKING AT LEAST 30 HOURS A WEEK
• Medical Plan Options:
• I. PPO plan with copay/coinsurance and lower deductible
• II. High Deductible Health Plan with the option for a Health Savings Account.
• III. Telemedicine includes in both plan options.
• Dental
• Vision
• Life Insurance/ Accidental Death and Dismemberment Insurance
• Disability Insurance with a Short and Long Term Option.
• Critical Illness and Accident Plans
• Cafeteria Options: Health Reimbursement/ Flex Savings

A host of other options to include: Pet Insurance, Identity Protection, Travel protection.

Education

High School or better.

Experience

Must have at least two (2) years of experience in the medical field and a minimum of one (1) year experience working with insurance companies.

Licenses & Certifications

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.