Prior Authorization Specialist

Role overview

Heart of the Rockies Regional Medical Center is seeking a Prior Authorization Specialist who is organized, accurate, and committed to helping patients move through the healthcare process smoothly. In this role, you will help make sure patients receive timely access to needed care by coordinating authorizations with providers and insurance payers.

You will act as a central point of contact between healthcare teams, patients, and insurance companies to secure approvals for services, procedures, and admissions. The position also supports efficient reimbursement workflows while contributing to high-quality patient care.

About the organization

Heart of the Rockies Regional Medical Center (HRRMC) is a community-focused healthcare provider located in the Rocky Mountains. The organization delivers a wide range of medical services, including emergency care, surgery, imaging, and more, with an emphasis on compassion, innovation, and patient-centered care. HRRMC also values a supportive environment for employees and a positive impact on the surrounding community.

Remote work eligibility

This role can be performed remotely only if you live in one of the following states: AL, CO, FL, GA, KS, MO, MT, OK, PA, or WY.

Responsibilities

• Check provider orders, patient details, insurance coverage, and benefit information to support correct registration and authorization handling.
• Secure and record prior approvals for services based on payer rules, contractual terms, and clinical documentation standards.
• Work with provider offices, patients, internal departments, and insurance payers to collect required demographic, insurance, and clinical information and to resolve approval-related issues.
• Keep authorization documentation accurate and up to date, route accounts to financial counseling when needed, and assist with appeals and denials tied to authorization requirements.

Requirements

• At least 3 years of experience in customer service, healthcare administration, a medical office, or a similar business environment.
• Prior work in a hospital, physician practice, clinic, or other healthcare setting is preferred.
• Strong planning and organizational abilities with the capacity to juggle multiple priorities and deadlines.
• Clear communication skills and solid problem-solving capability.
• A careful, collaborative approach with a strong focus on accuracy and patient service.
• Must successfully complete pre-employment screening, including a background check, drug test, and verification of current immunizations.

Perks and benefits

• Retirement plans with employer matching.
• Medical, dental, and vision coverage.
• Access to the employee gym.
• Employee assistance program.
• Competitive compensation and a comprehensive benefits package.

Additional information

This is a full-time opportunity. The employer is an equal opportunity employer. Employment offers are contingent on successful completion of all pre-employment requirements, including background screening, drug screening, and proof of current immunizations. More details about the benefits package are available in the company benefits guide.