Do you enjoy working with friendly and helpful people in a positive work environment? Are you ready to embrace a career that offers a variety of learning opportunities? Are you looking to make a positive impact on peoples' lives in our community?

Consider a career at Boulder Medical Center (BMC). We are 100% privately owned and Physician operated, we provide care in over 20 different specialties, have 90+ providers practicing today, we employ 325+ Healthcare Professionals, and we have locations through-out Boulder County, CO.

Summary: Boulder Medical Center (BMC) is currently recruiting for Medical Assistant (MA) and LPN candidates to join our team as a Medication Authorization Specialist! This position will work full-time 40 hours per week Monday through Friday.
Job Perks:

• Full-time employees are eligible for medical / dental / vision, flexible spending, company-paid life insurance and Short Term Disability (STD) as well as several voluntary benefit options, RTD EcoPass, 401(k), Paid Time Off (PTO) and six (6) paid holidays annually.
• Part-time employees are eligible for medical / dental / vision, company-paid life insurance, voluntary benefits, RTD EcoPass, and 401(k).
• Day shift schedules are Monday through Friday. There are occasional voluntary four (4) hour shifts on Saturday mornings from 8 am - 12 pm for several primary clinics (Family Medicine and Pediatrics).
• Experience working in both primary care and specialty care clinics.

• Performs daily review of incoming requests (faxed or electronic) for pre-authorizations for prescription medications and biologics for insurance products.
• Handles pre-certification process required by most insurance companies for non-formulary medications; Completes correct documentation in patient’s medical chart.
• Responds to phone calls from BMC physicians, nurses, and staff with managed care insurance questions regarding medications, investigates problems or inquiries by contacting appropriate insurance company, and communicates action or resolution to staff in a timely and professional manner.
• Answers routine managed care insurance questions from patients referring them to the appropriate insurance company or to their employer when necessary for further benefit information or interpretation of policy.
• Investigates and prepares appeals when claims are denied; Notifies health plan with appeal and notifies patient of appeal process and outcome.
• Works closely with BMC’s insurance companies regarding effective/termination dates and pre-authorization problems; Researches source documents, including review of patient’s medical chart, submits information necessary to resolve initial inquiry and receive payment.

• Must be knowledgeable about managed care insurance rules and regulations in order process referrals and pre-authorizations.
• Must be able to analyze detailed breakdowns of applicable managed care insurance coverage and use judgement and initiative in researching questionable charges and coverage.
• Must have accurate typing skills, strong computer knowledge and experience operating office machines such as printers and fax machines;
• Must possess basic math aptitude, professional manner, tact, pleasant telephone voice, ability to initiate correspondence using appropriate grammar, etc., ability to communicate appropriate insurance policy rules to patients (for managed care plans).

Requirements:

• LPN - Graduate of an accredited nursing program. Licensed by the Colorado State Board of Nursing or equivalent.
• MA -
  • Completion of a Medical Assistant (MA) education program.
  • Active EMT and / or Surgical Tech certification are acceptable credentials to substitute Medical Assistant (MA) education.
  • Completion of a bachelor’s degree with an concentration in science / health sciences are acceptable credentials to substitute Medical Assistant (MA) education. Applicant(s) must submit unofficial college transcripts for Medical Assistant (MA) job placement approval.

Experience:

• LPN - One (1) or more years nursing experience in a clinic or hospital, preferred.
• MA - Previous experience as a Medical Assistant in a clinic setting, preferred.

• LPN - $22.21 - $28.00/ per hour depending on experience
• MA - $18.36 - $23.50 / per hour depending on experience

Location:

• Boulder, CO

From: Boulder Medical Center

Benefits:

BMC offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and STD as well as voluntary benefits, RTD EcoPass, 401(k), Paid Time Off and 6 paid holidays annually. Part-time employees are eligible for medical/dental/vision, company-paid life insurance, voluntary benefits, RTD EcoPass, and 401(k).