Prior Authorization Specialist – Contract

Job Description:

  • 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

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
Buy Now

Remote Question and Answer

Virtual Assistant Question and Answer

Content Moderator Question and Answer

Customer Service Question and Answer

Video Game Tester Question and Answer

Apply Now →