Insurance Authorization Coordinator - Greater Maryland Pain Management
Overview
You will own the full insurance authorization lifecycle for clinical procedures, handling pre-certifications, eligibility checks, and documentation for a busy pain management practice. You will coordinate directly with insurance companies, patients, clinical staff, and facilities, ensuring every procedure is approved and documented. Your days will involve verifying benefits online or by phone, assigning ICD-10 and CPT codes, and monitoring new patient reports, all while working with minimal supervision. This role is perfect for a detail-oriented coordinator who can navigate payer requirements and keep operations moving without delays.
What You'll Do10
- 1Obtain and complete all insurance pre-certifications and authorizations for scheduled procedures, coordinating with payers and clinical staff.
- 2Verify insurance eligibility and benefits through phone or internet, updating policy information in patient charts.
- 3Check payment policies for scheduled procedures and secure prior authorization when required, confirming receipt of all documents pre-procedure.
- 4Assign appropriate ICD-10 and CPT codes pre-operatively based on clinical documentation and booking slips.
- 5Monitor the new patient report and maintain an organized list tracking the status of each pre-certification process.
- 6Communicate effectively with the procedure facility to ensure all authorization details are confirmed and shared.
- 7Notify primary care physicians for managed care plans that require PCP authorization before procedures.
- 8Serve as a resource for insurance, billing, and customer service questions from reception and other team members.
- 9Maintain complete and accurate documentation in patient charts, ensuring audit-ready records.
- 10Develop and sustain effective relationships with insurance companies, physicians, and medical office staff to streamline processes.
Requirements10
- 12+ years of experience in insurance authorization, pre-certification, or medical billing in a clinical setting.
- 2Proficient knowledge of insurance requirements, medical and clinical terminology, and medical necessity for procedure codes.
- 3Experience with certification and referral workflows, including ICD-10 and CPT coding.
- 4Ability to verify insurance eligibility and benefits via phone and internet, and update policy information accurately.
- 5Strong organizational skills to monitor new patient reports and manage pre-certification status lists.
- 6Excellent communication skills for coordinating with insurance companies, patients, clinical staff, and facilities.
- 7Ability to work with minimal supervision and prioritize tasks in a dynamic medical office environment.
- 8Familiarity with managed care plans, including PCP authorization requirements.
- 9Proficiency with electronic health records (EHR) and insurance verification systems.
- 10High school diploma or equivalent; certification in medical billing or coding (e.g., CPC) is a plus.
Salary Insight
Salary not disclosed in listing
Location
Required Skills
Similar open positions
Explore active roles that match your skills and interests.
Beth Israel Deaconess Medical Center, Inc.
VerifiedClinical Practice Assistant Medical Assistant Pain Management Center
Join the growing BILH team where you will own patient interactions and contribute to compassionate care at Beth Israel Deaconess Medical Center. This role offers a unique opportunity to impact chronic pain management and migraine treatment in a collaborative environment. You will support clinical operations and ensure seamless patient experiences.
Weill Cornell Medicine
VerifiedPre-Authorization Representative, Insurance Verification
You will own insurance verifications, eligibility checks, and prior authorizations for surgical procedures, visits, and diagnostic testing at Weill Cornell Medicine. You will manage the full authorization lifecycle from pre-certification to rescheduling, coordinating with referring doctors and patients daily. Working in a billing unit on the Upper East Side, you will collaborate with clinical staff and handle patient fees. This role offers a clear path to master healthcare billing workflows in a top-ranked medical institution.
Apex Recruiting Professionals
VerifiedMedical Assistant Prior Authorization Specialist
The role involves owning prior authorizations for specialty medications within a supportive collaborative culture that prioritizes people. Responsibilities include managing high volume authorizations and driving efficient revenue cycle processes.
Insight Global
VerifiedPre-Certification Specialist, Healthcare Authorization & Epic
You own pre-certification and prior authorization for outpatient surgeries at a 3+ year scale in Charlotte, NC. You receive referrals from provider offices, prioritize authorization requests by procedure type and urgency, and drive them through to scheduling. You work in Epic daily, navigating referrals and authorizations between systems, while coordinating with clinical and administrative teams. This role demands independence and speed: minimal training, immediate ramp-up, and a direct impact on patient experience.
Premier Medical Resources
VerifiedInsurance Verification Specialist, Facility & Revenue Cycle
You will own insurance verification for surgical procedures at a growing healthcare management company, ensuring financial clearance for 500+ monthly cases. You'll work with EMR systems and ICD-10 codes, collaborating with physicians, billing, and coding teams. This remote role starts with 30-90 days in-person training in Houston, then offers full-time flexibility. You'll resolve coverage issues, calculate patient costs, and secure accounts before surgery, directly impacting revenue cycle efficiency.
Chariot Leadership Services
VerifiedPrior Authorization Specialist, Medical Billing
A Prior Authorization Specialist at Chariot Leadership Services owns the full pre-certification cycle for a Medical Device client in Dallas, Texas. You verify insurance benefits, obtain pre-authorizations, and maintain documentation in the Electronic Medical Record (EMR). You work hybrid with Mondays and Fridays remote, and the contract converts to permanent after 4 months. Your work directly enables patient access to testing and treatment.