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

Community Hospital•Grand Junction, CO

10d•$19 - $22•Onsite

About The Position

Position Highlights: Position: Prior Authorization Schedule: Monday – Friday Location: Grand Valley Primary Care 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. 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 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 April 6, 2026 Be Extraordinary. Join Us Today! Community Hospital recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, Community Hospital is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual’s race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status. Community Hospital does not discriminate against any “qualified applicant with a disability” as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.

Requirements

High school diploma or equivalent.

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).