In-Office Insurance Prior Authorization Representative (Part-Time)

In-Office Insurance Prior Authorization Representative (Part-Time)
Location: Durango, CO – IN OFFICE ONLY (Not Remote)

We are seeking an experienced Insurance Prior Authorization Representative to join our ENT practice. This is a part-time, in-office position (24–28 hours/week) and is not eligible for remote work.

Pay: $26/hour

Requirements (must meet all):

• Current, hands-on insurance prior authorization experience (required)
• Experience with CoverMyMeds and payer authorization portals
• Strong understanding of insurance verification, medical necessity, and documentation requirements
• Ability to manage high-volume requests with accuracy and urgency

Responsibilities:

• Submit and track prior authorizations for procedures, imaging, and medications
• Communicate with insurance carriers, providers, and staff to obtain approvals
• Ensure all required clinical documentation is complete and accurate

We are looking for someone who can step in and contribute immediately—this is not an entry-level role.

Responsibilities

• Obtain prior authorization from insurance companies for various medical procedures and treatments by accurately submitting required documentation.
• Review patient medical records and ensure all necessary information is complete and compliant with HIPAA regulations.
• Communicate effectively with healthcare providers, insurance representatives, and patients regarding authorization status and additional requirements.
• Maintain detailed records of authorization requests, approvals, denials, and follow-up actions within the medical records system.
• Verify patient insurance coverage and eligibility prior to scheduled appointments or procedures.
• Collaborate with office staff to coordinate scheduling based on authorization approvals and patient needs.
• Stay current with updates in managed care policies, CPT coding, ICD-9/10 coding, and relevant insurance guidelines to ensure accurate processing.

Skills

• Strong understanding of managed care processes and insurance verification protocols.
• Experience working in a medical or dental office environment with familiarity in office procedures.
• Knowledge of HIPAA compliance standards related to patient privacy and data security.
• Proficiency in CPT coding, ICD-9/10 coding, and ICD coding systems used for billing and documentation.
• Excellent organizational skills with attention to detail when managing medical records and authorization documentation.
• Effective communication skills for liaising between healthcare providers, insurance companies, and patients.
• Prior experience in medical office administration or medical coding is highly desirable; dental office experience is a plus. Join our dedicated team as an In-Office Insurance Prior Authorization Representative (Part-Time) to help streamline administrative processes while supporting exceptional patient care through efficient insurance management.

Pay: $26.00 per hour

Benefits:

• 401(k) matching
• Flexible schedule

Experience:

• Insurance verification: 2 years (Required)

Ability to Commute:

• Durango, CO 81301 (Required)

Work Location: In person