Prior Authorization Specialist

Cochlear•Lone Tree, CO

1d•$24 - $26•Hybrid

About The Position

Change people’s lives and love what you do at Cochlear—the most recognized brand in hearing health care—helping people hear and be heard around the world, while being part of one of Denver Business Journal’s 2026 Best Places to Work honorees in Denver! In this role, you will be based in our Americas head office based in Lone Tree, CO. This role requires full in-person attendance during the initial training period and transitions to a hybrid work model based on performance, as assessed by your supervisor. If you bring experience in full-cycle prior authorization submissions and are eager to further develop your skills and advance your career, this is a fantastic opportunity to join the Reimbursement Operations team at the global leader in implantable hearing devices! Your success in this role is measured by your ability to facilitate all pre-claim activity for reimbursement orders while providing exceptional service to internal and external customers. Work collaboratively with your peers within a region setting where you will develop subject matter expertise, as well as with internal stakeholders in Billing and Collections, Customer Experience and other operations teams to provide the most efficient order process for our recipients.

Requirements

Bachelors or Equivalent Work Experience
2-3 years of experience ideally working with health insurance, including but not limited to: Insurance Verification, Prior Authorization, Coordination of Benefits, Out of Pocket cost estimate calculations
Proven ability to work collaboratively and positively in a team environment to build strong, professional relationships
Excellent computer skills (preferably in Microsoft Office) and experience utilizing common office resources (phone, fax, copier and email).
Excellent verbal and written communication skills

Responsibilities

Verify eligibility, investigate insurance benefits and validate coverage; calculate and collect recipient out of pocket estimates based on their deductible, coinsurance and out of pocket maximum
Navigate and utilize operational resources while managing orders following date and urgency prioritization workflow
Collect documentation based on payor requirements and medical professional preferred method
Evaluate medical documentation for accuracy, requirements and validity and submit to insurance for prior authorization when required
Communicate professionally, effectively and clearly with customers to ensure understanding and meet the customer need; engage with cross functional business partners to support reimbursement processes, orders and customers
Secure in network exceptions and negotiate one-time agreements with insurance payors in which Cochlear is non-participating