Prior Authorization Specialist - Radiation Oncology - Full Time
About Montrose Regional Health
The Montrose Regional Health is the leading healthcare provider in the Uncompahgre Valley, offering comprehensive services across 23 specialties and sub-specialties. It is a not-for-profit organization accredited by the Joint Commission, committed to providing high-quality healthcare and serving as the employer of choice in its communities.
About The Career
The Hospital Prior Authorization Specialist facilitates the prior authorization process from provider to payer to patient, ensuring timely health care diagnostics and treatments. They support providers and patients by securing payer authorization for medical services and optimizing health outcomes by minimizing treatment interruptions due to coverage restrictions or denials. Additionally, they help reduce the patient's financial risk by reviewing health plan benefits and coverage restrictions, and advising on any authorization delays or denials. They also minimize the hospital's financial risk by interpreting provider clinical documentation for medical necessity requirements, improving documentation where needed, and facilitating appeals for coverage denials.
All About You
- A high school diploma or GED
- Prior Authorization experience preferred
- Knowledge of core competencies and understanding of procedure authorizations
- Basic understanding of human anatomy
- Ability to identify primary and secondary payers based on established guidelines
- Ability to prioritize workflow to meet deadlines
What We Offer
- Student loan employer contributions up to $10,800 tax-free!
- Mentoring
- Continuing Education
- 401K Retirement Plan with employer match
- Multiple health insurance options to choose from
Our Brand
- Integrity and honesty in all actions
- Service with care and compassion
- Excellence in leadership and innovation
- Creativity in delivering care
Team Culture
This position is located in Montrose, Colorado. The hospital values its team members like family and fosters a culture of care, innovation, and excellence.