Inpatient Authorization Specialist

Posted: January 21, 2020



Do you have a strong commitment to excellence and teamwork? Are you willing to care for our community with respect and compassion? Do you strive to always do the right thing?

If yes, you might be the Inpatient Authorizaiton Specialist we need!
At Holy Cross Medical Center, we are driven by our mission statement, "To provide our community with the best health care choices close to home in an environment of continual improvement."




Title: Inpatient Authorization Specialist

Department:  Patient Access

Description: Primary liaison between patients, providers and leadership.  

Location: Taos, NM - 1398 Wiemer Rd.

Education: High School Diploma or GED required.  Two Years of college or professional school preferred.

Shift: Varies

Duration: Full-Time

Position Details
Inpatient Authorization Specialist, Full-Time, 40 hrs/week, Varied Shifts.
Non-Exempt, Hourly, Bargaining.
Benefited position starting 1st day of the following month after hire.

Position Summary

The Outpatient Authorization Specialist functions as a primary liaison between patients, providers, and leaders throughout THS and reports to the Imaging Director. Also serves as a liaison between referring physicians, hospital facilities as well as all other collaborating relationships of THS. This position will also work in collaboration with any and all applicable departments.

As a Holy Cross Medical Center employee, you will immediately start accruing Personal Leave Time and Major Medical Leave time from day one. You will receive incredible Health, Vision and Dental benefits, paid partially by employee and employer with life insurance, short and long-term disability options. We offer a 403B pension plan, flexible spending accounts, employee discounts on HCMC hospital deductibles, bereavement leave, education opportunities, jury duty compensation, service awards, EAP and Professional Development Program opportunities.

To apply, please fill out an application and attached a current resume. Include gaps in employment and reasons for separation.

Criminal background check and pre-employment drug screen required upon conditional job offer.

Holy Cross Hospital is located in Taos, New Mexico. Taos is a friendly county seat located in Northern New Mexico roughly 40 minutes from Colorado's southern border. With clean rural living, we are located just 65 miles from the capital of Santa Fe, NM, 4 hours from Denver and 2 hours from Albuquerque. At 6,969 feet of elevation, there is outdoor recreation everywhere, quality schools with lots of sun and snow. We have four ski/snowboarding resorts located within 30 minutes of Taos, to include the world famous Taos Ski Valley, hiking, biking, fishing, rafting, golfing, hunting and over 400 years of history.

Holy Cross Medical Center is an equal opportunity employer and, as such, considers individuals for employment according to their abilities and performance. Employment decisions are made without regard to race, age, religion, color, sex, national origin, physical or mental disability, marital or veteran status, sexual orientation, genetic information or any other classification protected by law. All employment requirements mandated by local, state and federal regulations will be observed.

Schedule: Full-Time
Contact: Anthony Ralph
Phone: 575-751-5782
Email: aralph@taoshospital.org


Position Duties:

  • Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
  • Request, track and obtain prior-authorization from insurance carriers within time allotted for outpatient imaging, surgery and lab services
  • Request, follow up and secure prior-authorizations prior to services being performed
  • Works in collaboration with medical sites to obtain any additional clinical documentation that can be forwarded to insurance carrier
  • Provides direct support to primary care practices and specialty care providers regarding utilization, authorization, and referral activities
  • Proficient in the use of ICD-9 and CPT codes. (ICD-10 preferred)
  • Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations
  • Communicate any insurance changes or trends among team
  • Maintains a level of productivity suitable for the department
  • Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format
  • Other duties as assigned.

Position requirements:

  • High School diploma or GED with Two Years of College or Professional School preferred
  • Two years of experience working in the medical field
  • Familiarity with Electronic Medical Record required
  • Knowledge of online resources to obtain prior-authorizations
  • One year experience with ICD-9 and current with ICD-10, CPT codes.
  • Demonstrates overall knowledge of managed care plans
  • Comprehensive working knowledge of third party insurance processes required
  • Intermediate to expert knowledge and computer skills including Windows programs and database applications preferred. Includes good keyboard skills 45+ wpm with high accuracy rate
  • Understanding of insurance payor reimbursement, authorization, practice management systems follow-up helpful
  • Ability to prioritize tasks, work independently, and in a close environment with peers
  • Strong leadership skills with attention to detail and accuracy
  • Ability to communicate effectively

This Position is No Longer Available