Bilingual Prior Authorization & Procedure Scheduling Coordinator

This is a fully remote position, open to applicants in Nicaragua, +5 more countries.

📋 Description

• Secure prior authorizations for interventional pain management treatments.

• Confirm insurance benefits, eligibility, authorization prerequisites, and procedure coverage.

• Provide clinical documentation, procedure codes, diagnosis codes, and supporting records to insurance providers.

• Monitor pending authorizations and follow up until decisions are rendered.

• Relay approvals, denials, and further documentation needs to the clinical team.

• Assist with peer-to-peer reviews and appeals processes.

• Ensure precise authorization records are maintained in the EMR/practice management system.

• Identify authorization challenges early to avert delays or cancellations.

• Schedule injections, ablations, spinal cord stimulator procedures, peripheral nerve stimulation procedures, and other interventional treatments.

• Coordinate procedure dates and relay scheduling details to patients.

• Manage physician procedure schedules and resolve any scheduling conflicts.

• Facilitate scheduling with hospitals, ambulatory surgery centers, and other facilities.

• Submit scheduling forms, orders, authorizations, demographics, insurance details, and supporting documentation.

• Organize anesthesia coverage and communicate schedules or changes with anesthesia teams.

• Collaborate with medical device representatives and vendors regarding equipment, implants, supplies, and availability.

• Provide patients with details on procedures, preparation requirements, authorization status, and scheduling assistance.

• Promptly reschedule any canceled or postponed procedures.

• Maintain a well-organized procedure pipeline covering authorizations, scheduling, anesthesia, vendors, facilities, denials, cancellations, and follow-up actions.

• Meet performance standards for timely authorizations, accurate scheduling, prompt communication, documentation, and efficient case follow-up.

⛳️ Requirements

• Previous experience in medical prior authorizations and procedure scheduling is highly preferred.

• Experience in pain management, orthopedics, neurosurgery, spine surgery, or another specialty focused on procedures is highly desirable.

• In-depth knowledge of commercial insurance, Medicare, and managed-care authorization processes.

• Familiarity with CPT and ICD-10 coding.

• Experience in communication with insurance companies, hospitals, ASCs, anesthesia groups, and medical device representatives.

• Proficient computer and EMR/practice management skills.

• Exceptional organizational and multitasking capabilities.

• Strong written and verbal communication skills.

• Ability to work autonomously and follow through without constant oversight.

• Comfortable operating in a high-volume, fast-paced clinical environment.

• Bilingual capability is implied by the role title; specific languages are not specified.

🏝️ Benefits

• Full-time contractor role (40 hours per week).

• Pay rate is negotiable based on skillset and experience.

• Monday–Friday schedule, 8 AM–4 PM CST.