Prior Authorization Specialist
Flagler HealthAI-driven Clinical company
RemoteMid
SignalFire
186 Ventures
Streamlined Ventures Management
MassChallenge
Venture Initiation Program
Operations & Strategy
About the role
TL;DR
Manage prior authorizations for pain management and orthopedic procedures and medications.
- •Flagler Health is seeking a Prior Authorization Specialist to manage high-volume authorizations for procedures and medications in pain management and orthopedic clinics.
- •Key Responsibilities Submit and manage prior authorizations for pain management and orthopedic procedures.
- •Manage prior authorizations and reauthorizations for medications commonly used in pain management.
- •Navigate multiple payer portals efficiently and verify insurance eligibility and benefits.
- •Review provider documentation to confirm medical necessity and procedural alignment.
- •Follow up on pending or denied authorizations and identify documentation gaps before submission.
- •Requirements 3+ years of prior authorization experience in Pain Management or Orthopedics.
- •Demonstrated experience with interventional pain and/or orthopedic surgical authorizations and prescription drug prior authorizations.
- •Experience working on the clinic/provider side (not hospital/facility billing).
- •Ability to independently manage a high daily authorization volume.
- •Hands-on experience with payer portals and strong working knowledge of CPT codes and procedural terminology.
Domain expertise
healthcare