Prior Authorization Specialist

Job overview

The Prior Authorization Specialist role is onsite in Louisville, KY. Compensation is not specified. The role supports Commonwealth Pain & Spine, a pain management network focused on respectful, innovative, safe, and clinically proven pain relief. The specialist manages prior and retroactive authorization requests so ordered or scheduled services have the required payer approvals and documentation. The role coordinates with departments, insurers, patients, and other authorization staff, follows up on denials and recertifications, and helps keep provider schedules and patient records current.

What you'll do

• Collect required documentation and complete prior authorization orders
• submit prior and retroactive authorization requests accurately and on time
• obtain pre-certifications, authorizations, and referrals
• maintain knowledge of payer requirements
• document authorizations in patient records
• coordinate with authorization specialists, account representatives, and coders
• submit follow-up authorizations and recertifications
• appeal denials or arrange peer-to-peer reviews
• prescreen schedules and check daily add-ons.

What we're looking for

Skills & competencies

prior authorization specialist

louisville ky

commonwealth pain & spine

pain management

insurance authorizations

pre-certifications

referrals

patient records

denial appeals

cpt and icd-10

emr systems

Work arrangement

• Weekend coverage required

Why this role

Requires a high school diploma or GED. Two years of relevant authorization and referral experience is preferred; basic CPT and ICD-10 knowledge and EMR or billing-system experience are noted.

About the employer

Commonwealth Management LLC is hiring for this role. Industry: Offices of Physicians (except Mental Health Specialists). Sector: 62.