Pre-Authorization Specialist

Job Summary:

The Orthotics Pre-Authorization Specialist is responsible for managing all aspects of Durable Medical Equipment (DME) precertification and preauthorization within the Department of Orthopedics. This role requires strong attention to detail, accuracy, follow-through, and independent problem-solving to ensure timely authorization approvals and successful patient care workflows. The specialist is expected to operate with accountability, urgency, and professionalism in a fast-paced clinical environment.

Key Responsibilities:

Authorization & Insurance Workflow – 75%

• Manage end-to-end authorization workflow for DME/orthotics/prosthetics, including initiation, document collection, insurer follow-up, and tracking through completion.

• Submit authorizations through 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 escalate barriers to prevent workflow disruption or financial loss.

• Ensure timely and accurate documentation into EMR systems, including attaching required records and updating claim status.

Operational Excellence & Accountability – 10%

• 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 a 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.

Customer, Clinic, and Vendor Support – 10%

• 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.

Additional Responsibilities – 5%

• 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.

Work Location:

Onsite – this role is expected to work onsite and is located in Aurora, CO.

Why Join Us:

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. Our unique position at the forefront of medical science, education, and practice innovation translates in real-time to the most advanced patient care, unmatched in Colorado and the Rocky Mountain Region. From routine cases to the most complex, we treat every orthopedic condition including injuries and diseases of the bones, joints, nerves, tendons, ligaments, and muscles across many orthopedic specialties.

Why work for the University?

We have AMAZING benefits and offer exceptional amounts of holiday, vacation and sick leave! The University of Colorado offers an excellent benefits package including:

• Medical\: Multiple plan options

• Dental\: Multiple plan options

• Additional Insurance\: Disability, Life, Vision

• Retirement 401(a) Plan\: Employer contributes 10% of your gross pay

• Paid Time Off\: Accruals over the year

• Vacation Days\: 22/year (maximum accrual 352 hours)

• Sick Days\: 15/year (unlimited maximum accrual)

• Holiday Days\: 15/year

• Tuition Benefit\: Employees have access to this benefit on all CU campuses

• ECO Pass\: Reduced rate RTD Bus and light rail service

There are many additional perks & programs with the CU Advantage.

Qualifications:

Minimum Qualifications:

• High school diploma or GED 

• 3 years of healthcare administration or insurance authorization experience. Substitution\: A combination of related education and/or relevant experience in an occupation related to the work assigned equal to three (3) years.

Preferred Qualifications:

• Direct experience working in an authorization or billing roles, preferably DME, rehabilitation, or orthopedic specialty.

• Experience working with medical coding, insurance rules, and medical terminology.

• Experience working in EPIC or comparable EMR systems.

Conditions of Employment:

• Applicants must be legally authorized to work in the United States without requiring sponsorship. We are unable to provide work visa sponsorship or employment authorization for this position now or in the future.

Knowledge, Skills and Abilities:

• Strong attention to detail and accuracy — able to prevent and correct errors proactively.

• Demonstrated ability to independently prioritize workload and follow tasks through to completion.

• Critical thinking and problem-solving skills; ability to resolve issues without re-direction.

• Strong written and verbal communication skills.

• Excellent customer service and patient-centered approach.

• Ability to work effectively in a fast-paced environment and meet deadlines.

• Ability to collaborate and build positive working relationships at all levels.

• High degree of accountability, ownership, and reliability.

• Organizational skills including queue management and tracking systems.

• Ability to handle sensitive or emotionally charged situations professionally.

• Empathy and advocacy for patients.

How to Apply:

For full consideration, please submit the following document(s):

1. Curriculum vitae / Resume

2. Three to five professional references, including name, address, phone number (mobile number if appropriate), and email address

Questions should be directed to\: Joel Lewis, [email protected].

Screening of Applications Begins:

Screening begins immediately and continues until two weeks after date of posting.

Anticipated Pay Range:

The starting salary range (or hiring range) for this position has been established as $51,360-$61,632

The above salary range (or hiring range) represents the University’s good faith and reasonable estimate of the range of possible compensation at the time of posting. This position may be eligible for overtime compensation, depending on the level.

Your total compensation goes beyond the number on your paycheck. The University of Colorado provides generous leave, health plans and retirement contributions that add to your bottom line.

Total Compensation Calculator

Equal Employment Opportunity Statement:

CU is an Equal Opportunity Employer and complies with all applicable federal, state, and local laws governing nondiscrimination in employment. We are committed to creating a workplace where all individuals are treated with respect and dignity, and we encourage individuals from all backgrounds to apply, including protected veterans and individuals with disabilities.

ADA Statement:

The University will provide reasonable accommodations to applicants with disabilities throughout the employment application process. To request an accommodation pursuant to the Americans with Disabilities Act, please contact the Human Resources ADA Coordinator at [email protected]​.

Background Check Statement:

The University of Colorado Anschutz is dedicated to ensuring a safe and secure environment for our faculty, staff, students and visitors. To assist in achieving that goal, we conduct background investigations for all prospective employees.

Vaccination Statement:

CU Anschutz strongly encourages vaccination against the COVID-19 virus and other vaccine preventable diseases. If you work, visit, or volunteer in healthcare facilities or clinics operated by our affiliated hospital or clinical partners or by CU Anschutz, you will be required to comply with the vaccination and medical surveillance policies of the facilities or clinics where you work, visit, or volunteer, respectively. In addition, if you work in certain research areas or perform certain safety sensitive job duties, you must enroll in the occupational health medical surveillance program.