Prior Authorization Specialist I, Hospital Admissions, PRN/Pool

Yourcommunityhospital; Grand Junction (CO); On-site; USD 26,174 - 30,100; Part time

Benefits offered by this job

Life Insurance

Free Parking

Paid time off

Education assistance

403(b) with employer matching

Wellness Program

Job summary

Yourcommunityhospital is seeking a Prior Authorization Specialist I for Hospital Admissions. This part-time position involves gathering patient information, verifying insurance coverage, and submitting pre-authorization requests to insurance companies. The role requires high school education and knowledge of medical terminology.

The position is located in Grand Junction, CO, and offers a competitive pay rate of $19.00 to $21.85 per hour, alongside additional benefits covering life insurance, education assistance, and a wellness program.

Qualifications

• High school diploma or equivalent required.
• Knowledge of medical terminology preferred.

Responsibilities

• Collect and review patient medical records and diagnosis codes.
• Verify patient information and insurance coverage.
• Prepare and submit pre-authorization requests to insurance companies.
• Monitor the progress of pre-authorization requests.
• Collaborate with healthcare providers for necessary documentation.
• Explain the pre-authorization process to patients.
• Maintain detailed records of requests, approvals, and denials.
• Ensure compliance with HIPAA regulations.

Skills

Knowledge of medical terminology

Education

High school diploma or equivalent

Job description

Prior Authorization Specialist I, Hospital Admissions, PRN/Pool

Job Category: Administrative

Requisition Number: PRIOR003946

• Part-Time
• On-site

Locations

Showing 1 location

Community Hospital
2351 G Road
Grand Junction, CO 81501, USA

Description

Position Highlights:

• Position: Prior Authorization
• Location: Hospital Admissions

Responsibilities:

• Gather Patient Information: Collect and review patient medical records, diagnosis codes, and procedure details to support the pre-authorization request.
• Verify Insurance Coverage: Confirm patient information and insurance coverage through verifying photo ID, insurance cards, and personal information.
• Submit Pre-Authorization Requests: Prepare and submit pre-authorization requests to insurance companies, adhering to their specific procedures and requirements.
• Follow Up: Monitor the progress of pre-authorization requests and follow up with insurance providers to expedite the approval process.
• Communicate with Healthcare Providers: Collaborate with healthcare providers to obtain any necessary documentation, notes, or additional information required for pre-authorization.
• Patient Education: Explain the pre-authorization process to patients, including potential out-of-pocket costs, and address any questions or concerns they may have.
• Document and Recordkeeping: Maintain detailed records of pre-authorization requests, approvals, denials, and communications with insurance companies and healthcare providers.
• Compliance: Ensure that all pre-authorization processes comply with relevant laws and regulations, including HIPAA (Health Insurance Portability and Accountability Act).

Requirements:

• High school diploma or equivalent.
• Knowledge of medical terminology preferred.

Compensation:

• $19.00 – $21.85 per hour, depending on education and experience.
• Discretionary bonuses, relocation expenses, merit increase, market adjustments, recognition bonuses, and other forms of discretionary compensation may be available.
• Life Insurance
• Free Parking
• Paid time off
• Education assistance
• 403(b) with employer matching
• Wellness Program
• Additional benefits based on employment status

Additional Information:

• Relocation: Must relocate to Grand Junction, CO 81505 before starting work.
• Work Location: In-person/onsite
• Application Deadline: Posting will remain open until June 30, 2026

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
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