We help turn clinics into virtual health systems
Prior Authorization Specialist – Contract
Location
United States
Posted
115 days ago
Salary
0
Seniority
Senior
Job Description
Prior Authorization Specialist – Contract
Flagler Health
• Ensure timely authorization approvals by managing the full lifecycle of prior authorization workflows • Submit and manage prior authorizations for pain management and orthopedic procedures • Manage prior authorizations and reauthorizations for medications used in pain management • Verify insurance eligibility and benefits prior to submission • Follow up on pending or denied authorizations • Maintain clear documentation within EHR and tracking systems
Job Requirements
- 3+ years of prior authorization experience in Pain Management or Orthopedics
- Experience with interventional pain and/or orthopedic surgical authorizations
- Prescription drug prior authorizations
- Experience with clinic/provider side (not hospital/facility billing)
- Ability to manage high daily authorization volume independently
- Experience with payer portals (e.g., Availity, UHC, Carelon/AIM, eviCore, Cohere, CoverMyMeds, etc.)
- Working knowledge of CPT codes and procedural terminology
- Experience reviewing documentation for medical necessity
- Exceptional attention to detail
Benefits
- Timely authorization approvals
- High-volume authorization workflow management
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