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Delta Health

Insurance Pre-Authorization Specialist

Career Insights for Medical Claims Processor / Representative

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What they do

A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.

$39,219 / year median in Colorado

-5% projected decline

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Job Description

Delta Health is seeking a detail-oriented Insurance Pre-Authorization Specialist to manage insurance verifications and obtain pre-certifications prior to scheduling services. This role is essential in preventing claim denials and ensuring a smooth patient experience.
Key Responsibilities:
Verify commercial, Medicare, and Medicaid insurance coverage Obtain required pre-authorizations from primary, secondary, and tertiary payers Review patient orders and ensure medical necessity requirements are met Communicate with insurance companies, patients, and referring offices Accurately document authorization details in Meditech or Athena Assist with resolving denied claims
Qualifications:
Experience with insurance verification and prior authorizations Strong attention to detail and accuracy Excellent communication and teamwork skills Ability to work independently in a fast-paced environment Why Join Delta Health? Comprehensive Benefits Package Medical, RX, Dental & Vision - Low premiums with 100% coverage on services provided within the Delta Health system, and no deductibles or co-pays. Includes access to massage therapy, acupuncture, and chiropractic care . Life & Disability Insurance - Employer-paid coverage for your peace of mind. Time Off - Over 4 weeks of paid vacation annually (including sick and personal leave) for full-time staff. Retirement - 403(b) plan with up to a 2 % employer match . Work-Life Balance in a Stunning Location Located on the Western Slope of the Rocky Mountains, Delta offers an unmatched combination of small-town charm, affordability, and natural beauty. Enjoy year-round outdoor activities such as hiking, skiing, mountain biking, fishing, and exploring the Grand Mesa and surrounding public lands. Whether you're raising a family or looking for work-life balance, Delta provides a safe, friendly community with a slower pace and a high quality of life. Delta is surrounded by the Grand Mesa, Uncompahgre Plateau, and nearby wineries, offering a unique blend of adventure and relaxation. Delta Health is a county-wide healthcare system with more than 100 years of dedication to serving our community. Our 49-bed hospital and outpatient locations across Delta County are committed providing remarkable care in a healing environment . We operate with the core belief: Excellence. Every Patient. Every Time .