Prior Authorization Specialist at BoulderCentre for Orthopedics and Spine

Boulder, Colorado, United States -

Full Time

Start Date

Immediate

Expiry Date

10 Apr, 26

Salary

29.0

Posted On

10 Jan, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Billing, Authorization, Insurance Verification, Pre-Certification, Customer Service, Communication, Organization, Multitasking, CPT Coding, ICD-9 Coding, Medicare Compliance, HIPAA, OSHA, Documentation, Workflow Prioritization, Patient Care

Industry

Hospitals and Health Care

Description

Description Job Overview: Join our medical billing team as an Authorization Specialist. This role includes verifying insurance benefits, obtaining pre-certifications and authorizations from payors, submitting necessary documentation, and assisting patients with understanding their financial obligations. The specialist will monitor the authorization status of scheduled patients and reschedule appointments as necessary pending completed authorization. Department: Administrative Reports to: Prior Authorization Manager Schedule/Type: Full-Time M-F/ Hourly Overtime Status: Non-exempt Wage: $20-29.00 per hour, commensurate with experience Requirements Essential Job Responsibilities: Submit and follow up on authorization requests with insurance companies for internal MRI, therapy, surgery, and DME orders. Verify order contents and insurance coverage upon receipt, obtain pre-authorization, and communicate benefits eligibility and financial details to patients and practitioners. Notify patients and practitioners of any services requested that are not authorized by insurance. Review upcoming schedules for authorization status and contact patients with payment/rescheduling options if authorization is not obtained. Utilize intraoffice communication and resources to support the authorization process. Prioritize workflow based on authorization timeframes, insurance requirements, and urgency. Obtain retroactive authorizations as needed. Maintain accurate and timely documentation and records for continuity of patient care. Perform other duties as assigned. Education/Experience: High school diploma or GED required. College degree preferred. Minimum of 2 years of experience in medical billing/authorization. Experience in an orthopedic setting preferred. Familiarity with pre-authorization, pre-certification, and health insurance claims processing Performance Requirements: Knowledge of insurance processes, third-party payers, basic coding (CPT, ICD-9), Medicare compliance, OSHA, HIPAA, and relevant regulations. Skills in written and verbal communication, customer service, math, and organization. Ability to prioritize tasks, multitask, and work effectively in a fast-paced environment while maintaining cooperative relationships with staff and patients. Company Paid Benefits Basic Life/AD&D –Guardian 16 days of PTO per year 7-7.5 paid holidays per year Employee Assistance Program 401(k) Safe Harbor Contribution Benefit Options Requiring Employee Contributions Medical Health Savings Account Dental Vision Short-Term Disability Voluntary Life and AD&D Flex Spending Accounts General Purpose Healthcare FSA Optional Protection Benefits (Accident, Hospital Indemnity, Cancer Care and Critical Illness Insurance) 401(k) Closing Date: January 31st,2026 Boulder Centre for Orthopedics is proud to be an Equal Opportunity employer. We are committed to providing equal employment opportunities to all qualified individuals without regard to race, color, religion, sex, national origin, age, disability, genetic information, marital status, sexual orientation, gender identity or expression, veteran status, or any other characteristic protected by applicable law. Our hiring decisions are based solely on qualifications, merit, and business needs. We encourage diverse candidates to apply and welcome the opportunity to build a talented and inclusive workforce. In our recruitment and employment practices, we adhere to applicable federal, state, and local laws, ensuring fairness and inclusivity in all aspects of employment. We value diversity and believe that a diverse workforce enhances our ability to serve our patients and community effectively. All qualified individuals are encouraged to apply, regardless of background or identity.

Responsibilities

The Prior Authorization Specialist is responsible for verifying insurance benefits, obtaining pre-certifications and authorizations, and assisting patients with their financial obligations. They will also monitor authorization statuses and reschedule appointments as necessary.