Boulder Care
healthcare
PriorAuthorizationSpecialist
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“Prior Authorization Specialist at Boulder Care. Skills: prior authorizations, insurance verification, patient communication. Obtain prior-authorization for all patients. Verify patient insurance information”
What You'll Achieve.
Improve patients' medication adherence by offering a quick and effortless way for patients to get their medications on time
Industry & Context.
Troubleshoot prior authorization submissions and prescription processing; Review and resolve all reported authorization issues timely and effectively; Team player that can also solve problems independently
Dedicated, private workspace with a lockable door, High-speed internet, Authorized to work for any employer in the U. S.
What They're Looking For.
Must Have
6 months of experience working on prior authorizations, 2+ years of Medical office/clinic experience, Ability to organize workload and manage time effectively, Technologically savvy, Ability to read and interpret medical benefits for verification requests, Ability to handle a high volume of work with speed and accuracy, Access to reliable, high-speed internet
Nice to Have
Medical Assistant experience, Customer service experience, Remote/telehealth experience, A passion for serving the needs of people with addiction and mental health challenges, using non-stigmatizing, non-judgmental person-first language
What You'll Do.
Obtain prior-authorization for all patients
Verify patient insurance information
Troubleshoot prior authorization submissions
Review and resolve authorization issues
Submit prior authorizations to insurance plans
Communicate authorization and benefit coverage
Obtain appropriate documentation
Document progress of prior authorization
Follow up on pending authorizations
Navigate between multiple systems
Maintain patient file security and confidentiality
Advise management of identified trends
How You'll Work.
Team & Collaboration
Work closely with staff to review, research and complete prior authorizations; Work closely with our care team to ensure the success of patients; Team player that can also solve problems independently
Communication Scope
Exceptional written and verbal communication skills; Communicate authorization and benefit coverage with patients and providers promptly and professionally
Full Job Description
About Boulder Boulder Care is an award-winning digital clinic for addiction medicine, recognized for both innovation and high quality of patient care. Founded in 2017 by CEO Stephanie Strong, our mission is to improve the lives of people with substance use disorders through compassionate, evidence-based care. We provide Boulder patients with a fully virtual, multidisciplinary care team—including medical providers and peer recovery specialists—who deliver personalized treatment, including medication for opioid use disorder (MOUD) and ongoing support. Our approach is grounded in clinical excellence, patient-centered care, and a commitment to reducing barriers to recovery. Boulder partners with leading health plans, employers, and community organizations to ensure that our services are accessible and covered for the people who need them most. Named by Fortune as one of the Best Workplaces in Healthcare, we foster a culture of kindness, respect, and meaningful work that delivers outstanding patient outcomes and moves the addiction medicine industry forward. About the Role The Prior Authorization Specialist is responsible for obtaining all pre-authorizations for medication approvals. They will work closely with staff to review, research and complete prior authorizations, prior authorization appeals, and notify patients of status updates from insurance. The most important goal is to improve patients' medication adherence by offering a quick and effortless way for patients to get their medications on time. What You'll Do: Obtain prior-authorization for all patients requiring insurance approval for medication needs Verify patient insurance information is accurate and documented correctly Troubleshoot prior authorization submissions and prescription processing with health care providers utilizing phone or online resources Review and resolve all reported authorization issues timely and effectively Submit prior authorizations to insurance plans in a timely manner via payer-spe
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