Pre-Authorization Representitive

CommonSpirit Health • Colorado Springs, CO

17h • Onsite

About The Position

As our Pre-Authorization Representative, you will play a critical role in ensuring financial access to care by verifying insurance coverage and expertly obtaining all necessary authorizations and pre-certifications for ordered procedures and office visits. Every day you will utilize scheduling and registration information to verify patient benefits, secure required authorizations from insurance carriers or third-party vendors, meticulously document all approvals in hospital systems, and act as a vital liaison between patients, physicians, Radiation Oncology Administration, the centralized billing office, and community agencies. To be successful in this role, you will possess exceptional organizational skills, a meticulous attention to detail in verifying coverage and obtaining authorizations, strong communication abilities, and a deep understanding of insurance processes to ensure seamless patient access to care and efficient billing.

Requirements

• High School Diploma/G.E.D.
• Two (2) years experience in outpatient clinic, physician office or other health care setting

Responsibilities

• Conducts thorough eligibility checks for all patient types using various electronic and telephonic verification tools to ensure accurate coverage data.
• Initiates, obtains, and documents all necessary preauthorizations within the Clinical Information System while escalating issues to the administration team.
• Compiles CPT codes based on treatment prescriptions to assist financial counselors with patient cost estimates and self-pay financial assistance screening.
• Serves as a backup for exporting charges to the hospital billing system, ensuring all data is linked to the correct account numbers and resolving discrepancies.
• Maintains current knowledge of insurance regulations and reimbursement policies by attending meetings and participating in ongoing educational sessions.
• Maintains cross-functional competency by participating in team training and providing coverage for other administrative roles to ensure departmental efficiency.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED