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TYPE OF WORK
Full Time
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SALARY
35000-40000
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HOURS PER WEEK
40
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DATE UPDATED
Oct 25, 2026
Job Title: Prior Authorization Specialist (US Healthcare | Remote)
Eastern Time (US) – Monday to Friday (08:00 AM TO 05:00 PM)
Must be willing to work graveyard shift (PH time)
We are seeking a highly experienced Prior Authorization Specialist who can independently manage the end-to-end prior authorization process for a US-based healthcare practice.
The ideal candidate must be confident in handling high-volume submissions and able to complete at least 25–30 cases per day accurately and efficiently.
Key Responsibilities (End-to-End Process)
-Verify patient insurance eligibility and benefits
-Review provider orders and clinical documentation
-Submit prior authorization requests via portal, fax, or phone
-Upload required medical records
-Follow up with insurance companies for status updates
-Handle approvals, denials, and appeals
-Communicate status updates to providers and the internal team
-Document all actions accurately in EMR/EHR systems
-Ensure HIPAA compliance at all times.
Qualifications:
-Minimum of 1 year of Prior Authorization experience in a Pain Management setting.
-Strong knowledge of commercial insurance, Medicare, Medicaid, and workers' compensation authorization processes.
-Experience obtaining authorizations for pain management procedures, injections, imaging studies, and related treatments.
-Ability to track authorization status, follow up with insurance payers, and resolve denials.
-Familiarity with EMR/EHR systems and medical billing workflows.
-Excellent communication and organizational skills.
-Ability to work independently in a remote environment.
Preferred:
-Experience with interventional pain management procedures.
-Knowledge of CPT, ICD-10, and HCPCS coding related to pain management services.
Technical Requirements:
-Stable high-speed internet (minimum 70 Mbps)
-Noise-canceling headset
-Quiet home office setup
-Backup internet and power source preferred.
How to Apply:
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
