Prior Authorization Specialist — Healthcare Insurance Support

Twin Cities Pain Clinic; Edina (MN); On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

401(k)

PTO

Paid holidays

HSA plan

Job summary

Twin Cities Pain Clinic is seeking a detail-oriented Prior Authorization Specialist to review insurance information, determine authorization needs, and submit requests with documentation. The role supports the business office and coordinates with insurers, physicians, patients, and vendors to ensure timely approvals.

You will manage authorizations across Medicare, Commercial, Medicaid and workers’ compensation, maintain knowledge of guidelines, and assist with denials and appeals.

Qualifications

• High School Diploma or GED required.
• Associate’s or Bachelor’s degree preferred.
• Minimum 1 year of prior authorization experience in healthcare.
• Medical terminology preferred (CPT/HCPCS, ICD-10 Codes, Procedures).
• NextGen experience preferred.

Responsibilities

• Review patient insurance information to determine if prior authorization is required.
• Manage and process authorizations for Medicare, Commercial, Medicaid and workers’ compensation for injections and procedures.
• Identify insurance coverage and coordinate pre-procedure requirements with patients.
• Communicate with insurers, physicians’ offices, vendors, and patients.
• Assist with denials and appeals and maintain authorization documentation.
• Support billing and other duties as needed.

Skills

Detail oriented

Verbal communication

Written communication

Insurance knowledge

Problem solving

Computer proficiency

Self-directed

Teamwork

HIPAA compliance

Education

High School Diploma or GED

Associate’s or Bachelor's degree preferred

NextGen experience preferred

Tools

NextGen

Job description

Twin Cities Pain Clinic is seeking a detail-oriented Prior Authorization Specialist to review insurance information, determine authorization needs, and submit requests with documentation. The role supports the business office and coordinates with insurers, physicians, patients, and vendors to ensure timely approvals.

You will manage authorizations across Medicare, Commercial, Medicaid and workers’ compensation, maintain knowledge of guidelines, and assist with denials and appeals.