Prior Authorization Specialist (FT)

Family Health West•Fruita, CO

18d

About The Position

The Prior Authorization Specialist supports the authorization process for hospital and physician services. The role responds to calls from physician offices, hospitals, and patients; obtains necessary documentation from outside providers; contacts insurers to secure prior authorizations; assists patients with questions; and updates the electronic health record with authorization numbers, insurance details, and other relevant information. The specialist also scans documentation into patient charts, enters patient information accurately, and maintains confidentiality. The position works collaboratively with other departments and builds effective rapport with employees, patients, physicians, and vendors. It contributes to departmental workflows and operating procedures under the direction of the Coordinator or Manager, participates in workshops and training, follows standard operating procedures, and performs other related duties as assigned. Reliable, punctual attendance and timely, respectful communication are expected. The position requires working knowledge of general office equipment and use of Excel and reporting tools as needed for prior authorization. The starting wage is $19.65 and increases based on experience. Immunizations, including the flu vaccine, are required for employment. The position is full-time. Benefits available to all employees include an Employee Assistance Program and a 403(b) plan with a 4% employer match and immediate vesting. Full-time employees working at least 30 hours per week may access medical plan options, telemedicine, dental, vision, life and accidental death and dismemberment insurance, disability coverage, critical illness and accident plans, cafeteria-plan options, and additional options such as pet insurance, identity protection, and travel protection.

Requirements

Working knowledge of medical service lines in hospital services and/or physician services.
Working use of Excel and reporting tools as required for prior authorization.
Ability to use general office equipment, including a computer, telephone, keyboard, scanner, and mouse.
Accurate and timely computer entry and documentation practices.
Ability to communicate with understanding, patience, respectfulness, and kindness.
Reliable and punctual attendance.
Immunizations, including the flu vaccine, are required for employment.

Responsibilities

Answer calls from physician offices, hospitals, and patients in a timely and efficient manner using exceptional customer service skills.
Request documentation and information from outside providers needed to complete prior authorizations.
Obtain prior authorizations by contacting patients’ insurance companies and assist patients with questions.
Develop departmental organization, workflows, and operating procedures under the direction of the Coordinator or Manager.
Update the electronic health record with authorization numbers, insurance information, and other relevant information.
Enter patient information accurately and in a timely manner.
Obtain authorizations and scan documentation into patient electronic charts in a timely manner.
Maintain patient confidentiality.
Communicate necessary information and build effective rapport with employees, patients, physicians, and vendors.
Work collaboratively with other departments and follow standard operating procedures.
Participate in department workshops and training.
Use problem-solving skills and perform other job-related duties as assigned.
Maintain reliable and punctual attendance.