Prior Authorization-Pain Management

About the job

Company Description Staffingly, Inc. is a healthcare outsourcing partner focused on helping medical organizations overcome staff shortages and revenue challenges through specialized support services. The team is composed of highly qualified professionals with advanced degrees and HIPAA certifications, delivering compliant and secure services around the clock. Staffingly provides solutions such as prior authorization, insurance verification, medical reception, telemedicine support, medical data entry, medical coding, scribing, and revenue cycle management. The company emphasizes cost efficiency, expertise with healthcare software, and high-quality patient customer care to enhance operations and improve patient experiences. Clients can explore services through a 15-day free trial, gaining insight into how Staffingly can streamline workflows and reduce operational costs.

Role Description The Prior Authorization – Pain Management role is a full-time, remote position responsible for coordinating and securing timely authorizations for pain management treatments and procedures. Day-to-day tasks include reviewing clinical documentation, verifying insurance coverage and benefits, and submitting prior authorization requests to payers in accordance with their guidelines. The role involves following up on pending authorizations, resolving denials or requests for additional information, and accurately documenting all activities in the appropriate systems. The individual will collaborate with clinicians, billing teams, and patient support staff to minimize delays in care and ensure compliance with payer policies and regulatory requirements. The position also requires maintaining up-to-date knowledge of payer rules related to pain management services and contributing to process improvements that support efficient revenue cycle operations.

Qualifications

• Prior authorization and insurance verification skills, with experience in pain management or related specialties.
• Knowledge of medical terminology, CPT/ICD coding basics, and familiarity with payer guidelines for pain management services.
• Proficiency with healthcare practice management systems, electronic health records (EHR), and payer portals.
• Strong attention to detail, documentation accuracy, and organizational skills for managing multiple authorization requests.
• Effective communication skills for collaborating with clinicians, payers, and internal teams in a remote environment.
• Ability to interpret clinical notes and translate them into payer-required information for authorization submissions.
• Experience in revenue cycle management, denial resolution, or utilization management is beneficial.
• Prior work in a medical office, pain management clinic, or healthcare outsourcing environment is an advantage.
• High school diploma or equivalent required; post-secondary education in healthcare administration or a related field preferred.
• Commitment to confidentiality and compliance with HIPAA and other relevant regulations.