Surgical Prior Authorization Specialist — Scheduling & Compliance

BoulderCentre for Orthopedics and Spine; Boulder (CO); On-site; USD 42,000 - 58,000; Full time

Job summary

BoulderCentre for Orthopedics & Spine is seeking a Surgery Prior Authorization Specialist to join our Revenue Cycle team. This role ensures surgical procedures are properly authorized and financially prepared before a patient’s scheduled surgery.

The successful candidate is organized, detail-oriented, and comfortable working with insurance carriers, providers, and schedulers. You will review orders, submit authorizations, verify benefits, and communicate authorization status to the team to keep

Qualifications

• High school diploma or GED required.
• At least 2 years of experience in medical insurance, prior authorization, or medical billing.
• Experience with insurance companies and payer portals.
• Strong knowledge of insurance benefits and prior authorization processes.
• Familiarity with CPT and ICD-10 coding.
• Excellent attention to detail and organization.
• Ability to manage multiple cases and deadlines in a fast-paced environment.

Responsibilities

• Obtain and manage prior authorizations for surgical procedures.
• Verify insurance eligibility, benefits, authorization requirements, and payer guidelines.
• Review orders and documentation to meet authorization requirements.
• Submit authorization requests via payer portals, phone, or other channels.
• Track authorizations and follow up to ensure timely determinations.
• Identify and communicate authorization status and any restrictions or denials.

Skills

Medical billing

Revenue cycle

Insurance portals

Payer guidelines

Detail oriented

Education

High School Diploma or GED

Healthcare administration (preferred)

Tools

EMR/Practice management systems

Web-based insurance portals

Job description

BoulderCentre for Orthopedics & Spine is seeking a Surgery Prior Authorization Specialist to join our Revenue Cycle team. This role ensures surgical procedures are properly authorized and financially prepared before a patient’s scheduled surgery.

The successful candidate is organized, detail-oriented, and comfortable working with insurance carriers, providers, and schedulers. You will review orders, submit authorizations, verify benefits, and communicate authorization status to the team to keep