Remote Prior Authorization Specialist – Pain Management

Painpoint-Health; United States; Remote; USD 40,000 - 44,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

PTO

401(k)

Job summary

DxTx Pain & Spine is seeking a dedicated Prior Authorization Coordinator to verify benefits and obtain authorizations for advanced interventional procedures. You will interact with payors, practices, vendors, and patients to ensure timely approvals and accurate documentation.

Responsibilities include reviewing clinical information, navigating payer portals, and maintaining robust authorization trackers. This role supports a remote, full-time schedule with standard business hours and a focus on

Qualifications

• 2+ years in prior authorization or benefits verification.
• Experience verifying benefits and obtaining authorizations for advanced procedures (SCS, PNS, MILD, SI joint fusion).
• Working knowledge of Medicare, Medicare Advantage, Medicaid, and commercial payer requirements.
• Experience reviewing clinical documentation against payer policies and identifying gaps before submission.
• Experience using payer portals and utilization management platforms/vendors such as Availity, EviCore, Carelon, or Cohere.
• Experience working within Pain Management required.
• Strong organizational, analytical, and problem-solving skills.
• Proficient in Microsoft Office Suite.
• Knowledge of HIPAA privacy and security requirements.
• High School Diploma or GED.

Responsibilities

• Verify insurance eligibility and benefits for interventional and advanced procedures.
• Obtain prior and retro authorizations accurately and within required timelines.
• Work directly with payors, practices, vendors, and patients to secure necessary approvals.
• Review clinical documentation against payer policies and identify missing information before submission.
• Navigate payer portals and utilization management (UM) systems.
• Monitor authorization trackers and follow requests through completion.
• Document authorization activity and maintain accurate patient and claim information.
• Identify trends or issues that may delay authorizations or claims processing.

Skills

Prior Authorization

Benefits Verification

Interventional Pain

Documentation Review

Payer Portals

UM Systems

Microsoft Office

HIPAA Compliance

Organizational Skills

Education

High School Diploma or GED

Tools

Availity

EviCore

Carelon

Cohere

eCW

athenaOne

Smartsheet

Job description

DxTx Pain & Spine is seeking a dedicated Prior Authorization Coordinator to verify benefits and obtain authorizations for advanced interventional procedures. You will interact with payors, practices, vendors, and patients to ensure timely approvals and accurate documentation.

Responsibilities include reviewing clinical information, navigating payer portals, and maintaining robust authorization trackers. This role supports a remote, full-time schedule with standard business hours and a focus on