Senior Interventional Pain Authorization Specialist

Kansas Pain Consultants; Wichita (KS); On-site; USD 56,000 - 82,000; Full time

Benefits offered by this job

Competitive compensation

Health insurance

Dental insurance

Vision coverage

Life insurance

Paid time off

Retirement plan

Professional development

Flexible schedule

No nights

No weekends

No holidays

Job summary

Kansas Pain Consultants in Wichita, KS is seeking an EXPERIENCED Prior Authorization Specialist with a strong background in interventional pain management. This is a full-time, on-site role requiring meticulous, organized professionals who can move complex requests from submission to approval.

The candidate will interpret clinical documentation, navigate payer requirements, and communicate effectively with patients, providers, and insurance representatives.

Qualifications

• At least two years of prior authorization experience in a medical setting.
• Experience obtaining authorizations for procedures, imaging, medications, or surgeries.
• Strong understanding of commercial, Medicare, and managed-care processes.
• Ability to read clinical notes, imaging, and provider orders.
• Familiarity with CPT, ICD-10, HCPCS, and medical-necessity requirements.
• Excellent attention to detail, organization, and time management.

Responsibilities

• Obtain prior authorizations and pre-certifications for interventional procedures and tests.
• Manage authorizations for procedures such as injections, blocks, and implants.
• Verify patient eligibility, benefits, coverage limits, deductibles, and requirements.
• Review orders to confirm payer medical-necessity criteria are met.
• Identify missing information and obtain documentation from providers.
• Submit authorization requests via portals, phone, or other channels.
• Monitor pending requests and follow up until final determinations are received.
• Track authorization numbers, service codes, dates, units, and limitations.
• Confirm CPT and diagnosis codes match scheduled services.
• Prevent denials by addressing coverage issues before scheduling.
• Review denials and pursue reconsideration, peer-to-peer, or appeal as needed.
• Prepare appeal packets with supporting records and letters of necessity.
• Coordinate peer-to-peer reviews between providers and insurers.
• Maintain accurate notes and upload documents into EHR/PM systems.
• Communicate status and concerns clearly to patients and internal teams.
• Collaborate with scheduling, billing, and clinical staff to support care.
• Uphold HIPAA and payer policy compliance; stay current on policy changes.

Skills

Prior authorization experience

Medical coding knowledge

Interventional pain knowledge

Communication skills

HIPAA compliance

Job description

Kansas Pain Consultants in Wichita, KS is seeking an EXPERIENCED Prior Authorization Specialist with a strong background in interventional pain management. This is a full-time, on-site role requiring meticulous, organized professionals who can move complex requests from submission to approval.

The candidate will interpret clinical documentation, navigate payer requirements, and communicate effectively with patients, providers, and insurance representatives.