Insurance Authorization/Verification Specialist

Job Summary

We are seeking an experienced Authorization & Verification Specialist to support our Pain Management practice. This role is responsible for verifying insurance benefits and obtaining prior authorizations for pain management procedures, injections, imaging, and related services. The ideal candidate has a strong understanding of procedural authorizations, payer requirements, and the importance of accuracy to prevent delays in patient care.

Key Responsibilities

• Verify patient insurance eligibility, benefits, and coverage for pain management services
• Obtain and manage prior authorizations for pain management procedures, including but not limited to:
• Epidural steroid injections (ESIs)
• Facet joint injections and medial branch blocks
• Radiofrequency ablation (RFA)
• Spinal cord stimulator trials and implants
• Trigger point injections
• Imaging and diagnostic procedures as required
• Review clinical documentation to ensure medical necessity criteria are met
• Submit authorization requests with appropriate CPT/ICD-10 codes and supporting documentation
• Track, follow up, and resolve pending authorizations to avoid procedure delays
• Communicate authorization status and coverage details to providers, clinical staff, and patients
• Maintain accurate documentation in the EMR regarding approvals, denials, and authorization numbers
• Assist with appeals for denied or delayed authorizations when needed
• Stay current with payer-specific guidelines and pain management authorization requirements
• Support denial prevention and revenue cycle efficiency

Qualifications

• High school diploma or equivalent required; healthcare or billing certification preferred
• Minimum [2+] years of experience in prior authorizations and insurance verification, preferably in pain management or interventional specialties
• Strong knowledge of pain management procedures, CPT codes, and ICD-10 diagnosis coding
• Experience working with commercial insurance, Medicare, Medicaid, and Workers’ Compensation
• Familiarity with EMR/EHR systems and payer portals
• Understanding of medical necessity guidelines and clinical documentation requirements
• Excellent organizational, communication, and follow-up skills

Skills & Competencies

• Prior authorization expertise for interventional pain procedures
• Detail-oriented with strong analytical skills
• Ability to manage high-volume authorization requests
• Professional, compassionate patient communication
• Ability to work independently and as part of a multidisciplinary team

Benefits

• Competitive compensation
• Health, dental, and vision insurance
• Paid time off and holidays
• Retirement plan options
• Supportive team environment and growth opportunities

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Join us as an Insurance Authorization/Verification Specialist and become a crucial part of our healthcare team dedicated to delivering exceptional patient care through precise insurance management. Your expertise will help us improve service delivery while ensuring compliance with industry standards. Please text Michelle Odom at 631-481-6395 and send resume to [email protected].

Pay: $23.00 - $27.00 per hour

Expected hours: 30.0 – 40.0 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person