Pre-Authorization Representative

CommonSpirit Health Mountain Region is committed to building healthier communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen—both inside our hospitals and out in the community. With locations throughout Colorado, Utah, and Kansas, we deliver the same high standard of care to our employees as we do to our patients. Our 20 hospitals, emergency and urgent care centers, home care and hospice, Flight for Life Colorado^TM , telehealth and over 240 physician practices and clinics offer endless opportunities! Here, you can grow your career and impact the people in the communities you serve.

CommonSpirit Health is one of the nation’s largest nonprofit, faith-based health systems, with a team of over 150,000 employees and 25,000 physicians and advanced practice clinicians. CommonSpirit operates more than 2,200 care sites and 140 hospitals, serving some of the most diverse communities across the nation, letting humankindness lead the way.

$400/month Summit County housing stipend available for full time residents of Summit, Park, Eagle, Grand, Clear Creek, Lake, and Chaffee Counties.  Must work at least 80% physically on-site at a CommonSpirit Mountain Region site in Summit County and full time or part time status (PRN ineligible).  More details available upon offer.

You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills – but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success.

• Staff Development: This position maintains competence and effectiveness through regular staff communication within Radiation Oncology Admin team and other related areas, and by attending applicable meetings and educational sessions relating to insurance changes and reimbursement
  issues.
  • Insurance Verification: Verifies insurance benefits on all designated patient types using multiple means of verification (i.e. Medifax, Online Eligibility, Phone, etc.).
• This position notifies the radiation Oncology Admin team of issues, as necessary.
• Verification standards will be measured through various reporting mechanisms.
• Insurance Authorization: Initiates the pre-authorization process and documents actions taken in the Clinical Information Systems (CIS). Obtains authorization for assigned patients.
• Patient Estimates & Pre-Screening: Assists the facility Health Benefit Advisor or Financial Counselor(s) with patient requests for estimates of services rendered by compiling appropriate CPT codes based on treatment prescription. This information is forwarded to the HBA or Financial
  Counselor for patient requests in addition to self-pay patients for pre-screening of appropriate
  financial assistance program.
• Charge Export: Assists the Radiation Oncology Supervisor as backup to export charges from Radiation Oncology software program to the hospital system for billing. This requires verifying the charges have the correct account number assigned to the charge.
• If the account number does not exist, this position works with the Business Support team to ensure the account number is created for the daily charge export.
• Business Support: This position is cross trained to other roles within the Radiation Oncology Admin team to ensure cross coverage in addition to an expanded knowledge base ensuring high quality teamwork.
• Customer Service: Actively seeks to promote and maintain a positive, professional, team oriented and service conscious environment, and contributes to the goals of the department and the healthcare system.
• Complies with all departmental and system policies and procedures.

In addition to bringing humankindness to the workplace each day, qualified candidates will need the following:

• Two years experience in outpatient clinic, physician office or other health care setting
• Experience with medical billing and coding preferred
• Knowledge of medical terminology and medical insurance payers.
• High School diploma and or GED required

Physical Requirements: Sedentary work -(prolonged periods of sitting and exert up to
10lbs force occasionally)

We believe in the healing power of humanity and serving the common good through our dedicated work and shared mission to celebrate humankindness. 

CommonSpirit Medical Group (CMG) offers providers a true opportunity to live their calling to care while experiencing the support of a built-in comprehensive network, vast resources, professional growth, trusted leadership, generous benefits and an amazing quality of life with locations in Colorado, Kansas and Utah. CMG is proud to connect providers and consumers through state-of-the-art technology, clinical resources and professional expertise to help people live healthier. Our coordinated services represent a full continuum of care – from preventive and early diagnoses to leading-edge treatment and life-saving critical care. CMG’s ability to deliver better health care value is the direct result of combining the best clinical tools, shared resources and medical expertise with a patient-centered approach that emphasizes CommonSpirit Mountain Region’s mission and commitment to quality, compassion and service.

We believe investing in our employees lets them know they truly matter. Your Total Rewards package includes compensation, benefits, retirement, wellness, leave, and other programs. Designed with your well-being in mind, we offer: 

• Several Medical, Dental, & Vision options.
• Spending Accounts including a Dependent Care FSA that can include an employer contribution
• Retirement account options with a generous employer match
• Tuition Reimbursement
• Student Loan Forgiveness, and so much more!

View more on our benefits HERE.