About this role
Position Summary
The Pain Management Authorization & Scheduling Coordinator is responsible for coordinating the administrative and insurance related functions of the pain management physician's practice. This position serves as the primary administrative support for the physician and manages procedure scheduling, insurance precertification and authorization, patient coordination, and related administrative responsibilities.
The ideal candidate is highly organized, detail oriented, comfortable communicating with patients and insurance carriers, and able to independently manage multiple priorities while ensuring procedures are authorized and scheduled efficiently.
Essential Duties and Responsibilities
Precertification and Prior Authorization
• Obtain prior authorization and precertification for pain management procedures, diagnostic testing, medications when assigned, and other services requiring payer approval.
• Verify insurance benefits, eligibility, authorization requirements, and applicable payer guidelines prior to scheduling procedures.
• Submit clinical documentation and authorization requests to insurance carriers and third party utilization management organizations.
• Track pending authorization requests and proactively follow up with insurance carriers until a determination is received.
• Communicate authorization requirements, denials, requests for additional information, and peer to peer requirements to the physician and appropriate clinical staff.
• Coordinate the submission of additional clinical documentation when required.
• Maintain accurate documentation of authorization numbers, effective dates, approved services, and payer communications within the patient's medical record.
• Monitor authorization expiration dates and ensure procedures are scheduled within approved timeframes whenever possible.
• Assist with authorization related denials and appeals by coordinating required documentation with the physician and clinical team.
Procedure and Patient Scheduling
• Schedule pain management procedures, follow up appointments, and other physician services.
• Coordinate procedure dates with patients, physicians, facilities, and clinical staff.
• Provide patients with scheduling information, procedural instructions, and other approved information related to their appointments.
• Confirm that required authorization and documentation are completed before scheduled procedures.
• Manage cancellations, rescheduling, and changes to the physician's procedural schedule.
• Maintain an organized scheduling workflow to minimize delays in patient care and maximize physician schedule utilization.
Physician Administrative Support
• Serve as the primary administrative support person for the assigned pain management physician.
• Manage and coordinate the physician's administrative schedule and practice related calendar as assigned.
• Assist with correspondence, forms, documents, phone calls, and other administrative requests.
• Coordinate meetings, appointments, and practice related obligations as needed.
• Assist with communication between the physician, patients, clinical staff, facilities, referring offices, and other departments.
• Maintain organized records and follow up systems for outstanding physician administrative items.
• Anticipate scheduling and administrative needs and communicate potential issues to the physician or management proactively.
General Responsibilities
• Maintain patient confidentiality and comply with HIPAA and all applicable practice policies.
• Provide professional and courteous communication to patients, physicians, coworkers, insurance representatives, and outside facilities.
• Maintain accurate documentation within the electronic medical record and other practice systems.
• Monitor assigned work queues and outstanding tasks to ensure timely completion.
• Participate in training and maintain knowledge of payer requirements and practice workflows.
• Perform additional duties consistent with the position as assigned by the physician or practice leadership.
Qualifications
• High school diploma or equivalent required.
• Prior medical office experience preferred.
• Experience with insurance verification, prior authorization, precertification, or medical scheduling strongly preferred.
• Pain management, orthopedic, spine, or procedural specialty experience preferred.
• Familiarity with commercial insurance, Medicare, workers' compensation, and automobile insurance requirements is preferred where applicable.
• Strong computer skills and experience working with electronic medical record and practice management systems.
• Strong organizational skills with the ability to manage multiple active cases and deadlines simultaneously.
• Excellent written and verbal communication skills.
• Ability to work independently, prioritize responsibilities, and follow outstanding items through completion.
• Strong attention to detail and ability to identify potential scheduling or authorization issues before they affect patient care.
Compensation
Rate: $26.00 per hour