Remote Prior Authorization Specialist (Pain & Spine)

PainPoint Health; United States; Remote; USD 26,000 - 29,000; Full time

Benefits offered by this job

Health, Dental & Vision Insurance

Short & Long-Term Disability

401(k) Retirement Plan

Remote Stipend

Paid Time Off (PTO)

Company Paid Holidays

Bonusly Employee Recognition Platform

Job summary

DxTx Pain & Spine seeks a motivated Prior Authorization Coordinator to verify benefits and secure authorizations for interventional pain procedures. This full-time remote role collaborates with payors, practices, and patients to ensure timely approvals.

You will review clinical docs against payer policies, navigate payer portals, and manage multiple authorizations while meeting deadlines. The ideal candidate has 2+ years of benefits verification or prior authorization experience, knowledge of

Qualifications

• 2+ years of prior authorization or benefits verification experience in interventional pain, spine, neurosurgery, orthopedics, or a closely related specialty.
• Direct 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 (Availity, EviCore, Carelon, Cohere).
• Experience working within Pain Management required.
• 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 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

Benefits verification

Prior authorization

Organizational skills

Attention to detail

Microsoft Office

HIPAA knowledge

Education

High School Diploma or GED

Tools

Availity

EviCore

Carelon

Cohere

eCW

athenaOne

Smartsheet

Job description

DxTx Pain & Spine seeks a motivated Prior Authorization Coordinator to verify benefits and secure authorizations for interventional pain procedures. This full-time remote role collaborates with payors, practices, and patients to ensure timely approvals.

You will review clinical docs against payer policies, navigate payer portals, and manage multiple authorizations while meeting deadlines. The ideal candidate has 2+ years of benefits verification or prior authorization experience, knowledge of