Prior Authorization Specialist I, Grand Valley Primary Care, Full Time

Community Hospital • Grand Junction, CO

11d • $19 - $22 • Onsite

About The Position

Position Highlights:

Position: Prior Authorization
Schedule: Monday – Friday
Location: Grand Valley Primary Care

Requirements

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

Nice To Haves

• Knowledge of medical terminology preferred.

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).

Benefits

• Medical, dental, vision insurance
• Life Insurance
• Free Parking
• Paid time off
• Education assistance
• 403(b) with employer matching
• Wellness Program
• Additional benefits based on employment status

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees