Prior Authorization Specialist – Contract

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Flagler Health

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2023

🤖 Artificial Intelligence

⚕️ Healthcare Insurance

🧘 Wellness

Artificial Intelligence • Healthcare Insurance • Wellness

Flagler Health is an innovative health technology company that empowers healthcare providers by leveraging artificial intelligence to enhance clinical and back-office operations. Their AI solutions, such as the AI Triaging Engine, streamline patient care processes, improve patient outcomes, and ensure efficient scheduling. Flagler Health focuses on optimizing the healthcare experience through data-driven insights, chronic care management, and remote monitoring, ultimately enabling providers to offer more personalized care to their patients.

📋 Description

• Ensure timely authorization approvals by managing the full lifecycle of prior authorization workflows • Submit and manage prior authorizations for pain management and orthopedic procedures • Manage prior authorizations and reauthorizations for medications used in pain management • Verify insurance eligibility and benefits prior to submission • Follow up on pending or denied authorizations • Maintain clear documentation within EHR and tracking systems

🎯 Requirements

• 3+ years of prior authorization experience in Pain Management or Orthopedics • Experience with interventional pain and/or orthopedic surgical authorizations • Prescription drug prior authorizations • Experience with clinic/provider side (not hospital/facility billing) • Ability to manage high daily authorization volume independently • Experience with payer portals (e.g., Availity, UHC, Carelon/AIM, eviCore, Cohere, CoverMyMeds, etc.) • Working knowledge of CPT codes and procedural terminology • Experience reviewing documentation for medical necessity • Exceptional attention to detail

🏖️ Benefits

• Timely authorization approvals • High-volume authorization workflow management