Prior Authorization Coordinator

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the complete authorization process for interventional pain management procedures.

• Track advanced procedures for each practice to pinpoint authorization opportunities.

• Gather all necessary documentation for prior authorizations.

• Assess medical necessity guidelines for procedures as outlined by Paycor.

• Submit prior and retro authorization requests to payors accurately and in a timely manner.

• Record account activities, updating patient and claim information to facilitate efficient claim processing.

• Recognize trends or issues that may cause delays in authorization or claims processing.

• Communicate effectively with practices, vendors, insurance companies, patients, and management to obtain required approvals.

• Deliver exceptional customer service to internal teams.

• Act as a backup for the Contact Center Team during peak scheduling call periods.

• Carry out other related tasks as assigned to ensure smooth operations and continuity of patient care.

⛳️ Requirements

• High School Diploma or GED (mandatory).

• At least 1 year of experience in prior authorization and a clinical setting (mandatory).

• Experience in Pain Management is essential.

• Proficient in Microsoft Office Suite.

• Strong analytical and problem-solving skills.

• Excellent organizational abilities and meticulous attention to detail.

• Understanding of HIPAA privacy and security regulations.

• Basic knowledge of medical terminology.

• Familiarity with payor portals and navigation of medical policies.

• Ability to sit for extended periods, communicate effectively, perform computer-based tasks, occasionally lift up to 25 lbs, and maintain close vision, depth perception, and focus adjustment.

🏝️ Benefits

• Health, Dental & Vision Insurance.

• Accident and Life/AD&D Insurance.

• Short & Long-Term Disability.

• Emergency Travel Assistance Program.

• ID-theft Protection Services.

• LifeMart Employee Discount Program.

• Health Savings Account (HSA).

• Health Management Tools.

• Paid Time Off (PTO).

• Company Paid Holidays.

• Paternal Leave.

• 401(k) Retirement Plan.

• Remote Stipend.

• Travel Reimbursement.

• Continuing Education Reimbursement.

• Bonusly (employee recognition platform).

• DailyPay (on-demand pay access).