Insurance Authorization Specialist

Description

Job Title: Insurance Verification & Pre-Authorization Specialist

Department

Revenue Cycle / Patient Access – Pain Management

Location:

Charlotte, NC

Schedule

Full-time, Monday - Friday

Position Summary

We are seeking a detail-orientedPRN Insurance Verification & Pre-Authorization Specialistto support our pain management practice by ensuring timely and accurate verification of patient insurance benefits and securing prior authorizations for procedures, imaging, and medications. This remote, as-needed role plays a critical part in optimizing patient access and revenue capture by minimizing delays in care due to insurance-related issues.

Key Responsibilities

• Verify insurance eligibility and benefits for new and existing patients across multiple payers.
• Initiate, track, and follow up on prior authorization requests for interventional procedures, diagnostic imaging, and high-cost medications.
• Document payer responses and required authorization details accurately in the EHR (e.g., eClinicalWorks).
• Collaborate with clinical and scheduling teams to resolve coverage issues and reduce appointment delays.
• Communicate with insurance companies, pharmacies, and third-party vendors regarding approval status and documentation needs.
• Maintain organized records of all verification and authorization activity.
• Assist with insurance-related patient communication, including education on coverage limitations or denials.
• Stay up to date on payer policies relevant to pain management services and medications (e.g., epidurals, nerve blocks, spinal cord stimulators, controlled substances).
• Support appeals or peer-to-peer scheduling when denials occur.
  
  

Qualifications

• High school diploma or equivalent required; associate’s or healthcare certification preferred.
• 2 years of insurance verification and/or prior authorization experience in a medical office (pain management preferred).
• Strong knowledge of commercial insurance, Medicare, Medicaid, and workers’ comp plans.
• Familiarity with CPT, ICD-10, and HCPCS codes.
• Experience with EHR systems (eClinicalWorks preferred).
• Ability to navigate payer portals and pre-certification platforms (Availity, AIM, CoverMyMeds, etc.).
• Excellent communication, documentation, and time management skills.
• Reliable internet and secure home workspace required.
  
  

Ideal Candidate Traits

• Self-starter who thrives with minimal supervision
• Highly organized with strong attention to detail
• Comfortable with change and fast-paced environments
• Prior experience in pain management or specialty care is a major plus
  
  

ECAA is an equal opportunity employer and does not discriminate against any applicant or employee on the basis of age, race, color, religion, sex, national origin, genetic information, disability, or other legally protected status.This policy extends to all terms, conditions, and privileges of employment, as well as the use of the Company's facilities and participation in all activities sponsored by the Company.