Prior Authorization Specialist

Clearway Pain; Pensacola (FL); On-site; USD 25,000 - 33,000; Full time

Job summary

Clearway Pain is seeking a Pre-Cert Coordinator to support the authorization workflow. You will verify benefits, obtain pre-authorizations, and manage specialty pharmacy processing where applicable.

You will coordinate with physicians, payors, and patients, maintaining HIPAA confidentiality and upholding high service standards. The role requires a high school diploma or equivalent with at least two years of related experience, solid Microsoft Office skills, and excellent communication abilities.

Qualifications

• High School Diploma, or equivalent with minimum 2 years related experience or an equivalent combination of education and/or experience.
• Knowledge of Internet and Microsoft Office software (MS Word, MS Excel, MS PowerPoint, MS Outlook).
• Excellent written and oral communication skills, including exceptional customer service.
• Ability to establish and maintain effective working relationships with doctors, clinical staff, coworkers and the public.
• Ability to work independently and in a team.
• Ability to follow verbal and written instructions.
• Flexibility in schedule.
• Patience and understanding during stressful patient health situations.
• Ability to multi-task and prioritize.
• Extreme attention to detail.
• Strong organizational skills.
• Ability to problem solve and reason.
• Meet predefined quality standards.
• Maintain professional attitude and appearance at all times.
• Working knowledge of CPT and ICD-10 coding rules.
• Strong insurance knowledge for third‑party payers.
• Working knowledge of healthcare field and medical terminology.
• Commitment to excellent customer service and professional conduct.

Responsibilities

• Verifies insurance benefits for all procedures and specialty medications.
• Coordinates with providers to obtain pre-authorizations and documents findings.
• Manages specialty pharmacy processing and delivery where applicable.
• Reviews clinical data against medical terms and authorizes requests.
• Collaborates with departments to ensure prior authorization protocols.
• Coordinates with physicians, insurance companies and patients.
• Acts as patient liaison between insurers and physicians.
• Communicates patient information with ASC’s and other stakeholders.
• Maintains HIPAA confidentiality.
• Participates in trainings and completes required in-services.
• Performs other duties as assigned.

Skills

Communication skills

Customer service

Organization

Education

High school diploma or equivalent

Tools

MS Word

MS Excel

MS PowerPoint

MS Outlook

Job description

Clearway Pain is seeking a Pre-Cert Coordinator to support the authorization workflow. You will verify benefits, obtain pre-authorizations, and manage specialty pharmacy processing where applicable.

You will coordinate with physicians, payors, and patients, maintaining HIPAA confidentiality and upholding high service standards. The role requires a high school diploma or equivalent with at least two years of related experience, solid Microsoft Office skills, and excellent communication abilities.