Prior Authorization Specialist – Pain Management

Work From Home | Full-Time | U.S. Healthcare Experience Required

We are seeking a candidate who has a strong understanding of pain management procedures, insurance authorization requirements, and payer-specific guidelines.

Please apply only if you have substantial prior authorization experience specifically in Pain Management. Candidates with general medical VA or insurance verification experience but no direct Pain Management prior authorization experience will not be prioritized.

Key Responsibilities:

Process and submit prior authorization requests for pain management procedures, treatments, and medications.

Verify insurance eligibility, benefits, and authorization requirements before scheduled procedures.

Handle authorizations for pain management services such as epidural steroid injections, facet joint injections, medial branch blocks, radiofrequency ablation (RFA), nerve blocks, spinal cord stimulator procedures, and other interventional pain management treatments.

Review clinical documentation to ensure all required records support medical necessity.

Coordinate with providers and clinical staff to obtain missing documentation, including clinical notes, imaging reports, treatment history, and other supporting records.

Follow up with insurance companies regarding pending, denied, or additional-information requests.

Monitor authorization statuses, expiration dates, and approval timelines to prevent delays in patient care.

Assist with authorization denials, reconsiderations, and appeals when necessary.

Maintain accurate records and timely updates in the practice management or electronic health record system.

Ensure compliance with HIPAA and patient information confidentiality requirements.

Qualifications:

Required: Full, hands-on Prior Authorization experience in Pain Management.

Previous experience working with a U.S.-based pain management clinic or practice is highly preferred.

Strong knowledge of pain management procedures, CPT codes, and insurance authorization requirements.

Familiarity with commercial insurance plans, Medicare, and other U.S. healthcare payers.

Experience navigating payer portals and handling authorization submissions, follow-ups, and denials.

Ability to review clinical documentation and identify missing information needed for approval.

Excellent written and verbal English communication skills.

Highly organized, detail-oriented, proactive, and capable of working independently.

Must be comfortable working full-time on a U.S. time zone schedule.

Must have a reliable computer, stable internet connection, and backup power or internet arrangements.

Work Setup:

Position: Prior Authorization Specialist – Pain Management

Work Arrangement: Remote / Work From Home

Schedule: U.S. business hours, based on the assigned shift (Monday to Friday)

We kindly ask that you send the following:

-Updated resume

-Summary of your end-to-end PA experience

-Average number of cases you handle daily

-EMR systems you have used

-Internet speed test result

Please send me a message here in my inbox (attach your cv) so we can proceed to the next step.

Thank you