DME Prior Authorization & Documentation Specialist

Medix™; Denver (CO); On-site; USD 32,000 - 36,000; Full time

Job summary

Medix seeks an Order Documentation & Authorization Specialist in Denver to review healthcare orders and prior authorizations for durable medical equipment (DME). This non-clinical role focuses on accurate documentation and ensuring insurance medical necessity requirements are met before submission.

The ideal candidate has 3+ years of healthcare documentation experience, excellent attention to detail, and strong communication skills to coordinate with internal teams while maintaining HIPAA

Qualifications

• High school diploma or GED required.
• 3+ years of experience reviewing clinical records or healthcare orders.
• Strong understanding of medical terminology and payer guidelines.
• Proficiency with Microsoft Office, including Excel, Word, and Outlook.

Responsibilities

• Review medical records, clinical notes, physician orders, and claims history for completeness and accuracy.
• Compare documentation against payer-specific medical necessity guidelines, internal policies, and standard operating procedures.
• Identify missing documentation, inconsistencies, or discrepancies and communicate findings to the appropriate internal teams.
• Document review findings, case status, and follow-up activities accurately in electronic systems.
• Prepare clear, organized summaries outlining documentation gaps and supporting information.
• Submit prior authorization requests through insurance payer portals, phone, or fax.
• Track authorization requests and conduct timely follow-up until a final determination is received.
• Research payer requirements and ensure authorization submissions contain all required documentation.
• Escalate complex cases or documentation questions to leadership or appropriate internal resources.
• Maintain strict HIPAA compliance and protect patient confidentiality.
• Meet established productivity, accuracy, turnaround-time, and quality expectations.
• Participate in training, calibration sessions, and workflow updates as payer requirements evolve.
• Assist with additional administrative and order documentation projects as needed.

Skills

Analytical skills

Attention to detail

Healthcare documentation

Strong written and verbal comms

Medical terminology interpretation

Multitasking in fast-paced environment

Education

High school diploma or GED

Tools

Microsoft Office (Excel/Word/Outlook)

Job description

Medix seeks an Order Documentation & Authorization Specialist in Denver to review healthcare orders and prior authorizations for durable medical equipment (DME). This non-clinical role focuses on accurate documentation and ensuring insurance medical necessity requirements are met before submission.

The ideal candidate has 3+ years of healthcare documentation experience, excellent attention to detail, and strong communication skills to coordinate with internal teams while maintaining HIPAA