Pre-Authorization Specialist

Pre-Authorization Specialist

University of Colorado Anschutz Medical Campus, Department of Orthopedics

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Job Title:

Pre-Authorization Specialist, Position #:  – Requisition #:38475

Job Summary:

The Orthotics Pre-Authorization Specialist is responsible for managing all aspects of orthotics DME precertification and preauthorization within the Department of Orthopedics. Requires strong attention to detail, accuracy, follow‑through, and independent problem‑solving to ensure timely authorization approvals and successful patient care workflows. Operates with accountability, urgency, and professionalism in a fast‑paced clinical environment.

• Manage end‑to‑end authorization workflow for DME/orthotics, including initiation, document collection, insurer follow‑up, and tracking through completion.
• Submit authorizations via online portals and direct phone communication with payers.
• Perform detailed benefits verification, including deductible/out‑of‑pocket amounts, coverage limitations, authorization requirements, and provider network status.
• Proactively identify missing information, resolve issues, and prevent delays by partnering with providers, clinic teams, and external insurance representatives.
• Track aging authorization requests and elevate barriers to prevent workflow disruption or financial loss.
• Ensure timely and accurate documentation into EMR systems, including attaching required records and updating claim status.
• Maintain ownership of work queue and authorization turnaround times, meeting defined productivity and accuracy expectations.
• Review clinical documentation, match against ICD–10/CPT coding, and ensure accurate alignment to ordering provider documentation.
• Demonstrate continuous improvement mindset by identifying bottlenecks, suggesting solutions, and participating in process optimization efforts.
• Maintain compliance with HIPAA, payer requirements, billing standards, and departmental guidelines.
• Serve as a knowledgeable resource for patients, providers, schedulers, and clinic staff regarding authorization status and benefit questions.
• Respond to calls and messages promptly to support a high‑quality patient experience.
• Collaborate with CU Medicine billing teams and assist with coordination between orthopedic providers and vendor partners.
• Support onboarding and maintenance of vendor relationships and pricing structure.
• Accept and process patient payments when applicable.
• Support departmental quality improvement initiatives and organizational service standards.
• Assist clinic operations and provider teams as necessary to support patient care and workflow efficiency.

Onsite – role to work at clinics within the Denver Metropolitan Area, including the Steadman Hawkins Inverness clinic in Englewood and the Foot and Ankle Center at Central Park.

The University of Colorado, Department of Orthopedics is a recognized global leader in the field and Colorado’s most trusted orthopedic group for adults and children. From routine cases to the most complex, we treat every orthopedic condition with advanced patient care and innovation.

• Medical:
  Multiple plan options
• Dental:
  Multiple plan options
• Additional Insurance:
  Disability, Life, Vision
• Retirement 401(a) Plan:
  Employer contributes 10% of gross pay
• Paid Time Off:
  Accruals throughout the year
• Vacation Days: 22/year (max accrual 352 hrs)
• Sick Days: 15/year (unlimited accrual)
• Holiday Days: 10/year
• Tuition Benefit:
  Employees have access to all CU campuses
• ECO Pass:
  Reduced rate RTD Bus and light rail service

• Bachelor’s degree in biological science, nutrition, nursing, health, human services, psychology, counseling, social work, or related field
• Equivalent combination of education and experience may substitute year-for-year for bachelor’s degree requirement
• One year of healthcare administration/insurance authorization experience

• 1–3 years in authorization or billing roles, preferably DME, rehabilitation, or orthopedic specialty
• Knowledge of medical coding, insurance rules, and medical terminology
• Experience working in EPIC or comparable EMR systems

• Strong…