Job: Prior Authorization Specialist

This position is remote eligible if you live in the following states: AL-CO-FL-GA-KS-MO-MT-OK-PA-WY.  

Prior Authorization Specialist

Are you detail-oriented, organized, and passionate about helping patients navigate the healthcare process? Join our team as a Prior Authorization Specialist and play a vital role in ensuring patients receive timely access to the care they need.

In this role, you will serve as the key liaison between healthcare providers, patients, and insurance payers to secure required authorizations for services, procedures, and admissions. Your work will help streamline the reimbursement process while supporting exceptional patient care.

Discover Your Career in the Heart of the Rockies!

At Heart of the Rockies Regional Medical Center (HRRMC), we’re more than just a healthcare facility—we’re a cornerstone of our community nestled in the breathtaking Rocky Mountains. With a commitment to excellence, compassion, and innovation, we offer state-of-the-art medical services, including emergency care, surgery, imaging, and much more.

Our mission is clear: to provide high-quality, patient-centered care while fostering the well-being of our community. We believe in making a positive impact not just through our healthcare services but also by creating a supportive and collaborative environment for our team members.

Education & Experience

What You'll Bring:

• A minimum of three years of customer service, healthcare administration, medical office, or related business experience.
• Previous experience in a hospital, physician practice, clinic, or healthcare setting preferred.
• Strong organizational skills with the ability to manage multiple priorities and deadlines.
• Excellent communication and problem-solving abilities.
• A commitment to accuracy, collaboration, and exceptional patient service.

Why HRRMC?

We offer :

• Employer-Matching Retirement Plans
• Full medical, dental and vision healthcare plans. 
• Employee Gym Access
• Employee Assistance Program

Ready to become a vital part of our team? Apply online now at www.hrrmc.com!
Your next career opportunity in healthcare starts here!

How You'll Make an Impact :

• Verify provider orders, patient demographics, insurance coverage, and benefits information to ensure accurate registration and authorization processing.
• Obtain and document required prior authorizations for services in accordance with payer requirements, contracts, and clinical documentation guidelines.
• Collaborate with provider offices, patients, departments, and payers to gather necessary demographic, insurance, and clinical information and resolve authorization issues.
• Maintain accurate authorization records, refer accounts for financial counseling when appropriate, and support appeals and denial management related to authorization requirements.

We offer competitive pay and a comprehensive benefits package to support your career growth and personal well-being. For details about our benefits, visit our Benefits Guide.

Ready to join our team? Explore current openings and apply today at HRRMC Careers. Start your journey toward a rewarding career and an adventurous life in our beautiful mountain community!

Employment offers are contingent upon successfully fulfilling all pre-employment requirements, including a background check, drug screening, and verification of current immunizations.

Equal Opportunity Employer