Authorization Specialist

Regional West Health Services•Scottsbluff, NE

10d

About The Position

Regional West Medical Center is seeking an Authorization Specialist to support timely, accurate prior authorization for patient services. This role is responsible for obtaining authorizations for surgeries, diagnostic and cardiac imaging, procedures, prescription medications, VA services, select durable medical equipment, and outside referrals. The Authorization Specialist plays a key role in ensuring services are approved, properly documented, and aligned with payer requirements—supporting seamless patient care and revenue integrity.

Requirements

High school diploma or equivalent required
Strong attention to detail and accuracy
Ability to multitask and prioritize in a fast‑paced environment
Basic computer skills and comfort with electronic health records
Excellent customer service, communication, and problem‑solving skills
Commitment to compliance, confidentiality, and patient‑centered care

Nice To Haves

Two or more years of healthcare experience preferred
Knowledge of insurance processes and medical terminology preferred

Responsibilities

Obtain prior authorizations for surgeries, diagnostic imaging, procedures, medications, VA services, DME, and referrals
Receive and process orders via the electronic health record or fax according to priority status
Verify patient insurance eligibility and benefits
Initiate authorizations through payer portals, phone, or fax, providing required clinical documentation
Document authorizations, approvals, denials, appeals, and communications in the electronic health record per protocol
Follow Prior Authorization policies, workflows, and quality metrics
Identify and resolve authorization discrepancies promptly
Coordinate with providers, clinical staff, and internal teams to ensure services align with approved authorizations
Maintain confidentiality and comply with HIPAA and organizational policies
Adapt to changing workflows and departmental needs