The Prior Authorization Coordinator is responsible for verifying insurance benefits and obtaining authorizations for complex interventional pain and spine procedures. They will collaborate with clinical teams and payers to ensure documentation meets coverage criteria and facilitates timely patient access to care.
About DxTx Pain & Spine At DxTx Pain & Spine, we’re redefining how pain and spine practices thrive. As a physician-aligned partner organization, we empower independent, award-winning physicians across the country by combining clinical autonomy with strong
The Opportunity As a Prior Authorization Coordinator, you’ll help ensure patients receive timely access to interventional pain and advanced procedures. You’ll be responsible for verifying benefits, reviewing clinical documentation, navigating payer requirements, and obtaining prior authorizations for complex procedures.
What You’ll Do Benefits Verification & Authorization
Verify insurance eligibility and benefits for interventional and advanced procedures.
Obtain prior and retro authorizations accurately and within required timelines.
Work directly with payors, practices, vendors, and patients to secure necessary approvals.
Review clinical documentation against payer policies and identify missing information before submission.
Navigate payer portals and utilization management (UM) systems.
Monitor authorization trackers and follow requests through completion.
Document authorization activity and maintain accurate patient and claim information.
Identify trends or issues that may delay authorizations or claims processing.
Advanced Procedure Experience
Verify benefits and obtain authorizations for advanced procedures, including:
Spinal Cord Stimulator (SCS) trials and permanent implants
Peripheral Nerve Stimulation (PNS)
Minimally Invasive Lumbar Decompression (MILD)
Sacroiliac (SI) joint fusion
Other advanced interventional pain and spine procedures
Collaboration & Communication
Communicate with practices, insurance companies, vendors, patients, and management.
Provide excellent customer service to internal teams and patients.
Collaborate with clinical and administrative teams to ensure authorization requirements are met.
Serve as a backup to the Contact Center Team during peak scheduling periods.
Perform other related duties as assigned.
Required Qualifications
2+ years of prior authorization or benefits verification experience in interventional pain, spine, neurosurgery, orthopedics, or a closely related specialty.
Direct experience verifying benefits and obtaining authorizations for advanced procedures, such as SCS, PNS, MILD, and SI joint fusion.
Working knowledge of Medicare, Medicare Advantage, Medicaid, and commercial payer requirements, including LCD/NCD coverage criteria.
Experience reviewing clinical documentation against payer policies and identifying gaps before submission.
Experience using payer portals and utilization management platforms/vendors such as Availity, EviCore, Carelon, or Cohere.
Experience working within Pain Management required.
Strong organizational, analytical, and problem-solving skills.
Excellent attention to detail and ability to manage multiple authorizations and deadlines.
Proficient in Microsoft Office Suite.
Knowledge of HIPAA privacy and security requirements.
Basic understanding of medical terminology.
High School Diploma or GED.
Preferred Qualifications
Experience handling denials, peer-to-peer coordination, and appeals.
Experience with eCW, athenaOne, or Smartsheet.
Experience identifying authorization or documentation issues before submission.
Experience working in a fast-paced, multi-practice healthcare environment.
What We Offer
Health, Dental & Vision Insurance
Accident and Life/AD&D Insurance
Short & Long-Term Disability
Emergency Travel Assistance Program
ID-theft Protection Services
LifeMart Employee Discount Program
Health Savings Account (HSA)
Health Management Tools
Paid Time Off (PTO)
Company Paid Holidays
Parental Leave
401(k) Retirement Plan
Remote Stipend
Travel Reimbursement
Continuing Education Reimbursement
Bonusly Employee Recognition Platform
DailyPay
Ready to Make a Difference? If you have experience navigating complex benefits and authorization requirements for advanced pain and spine procedures, we’d love to hear from you. Apply today and help patients access the care they deserve.
An Equal Opportunity Employer
We do not discriminate based on race, color, religion, national origin, sex, age, disability, genetic information, or any other status protected by law or regulation. It is our intention that all qualified applicants are given equal opportunity and that selection decisions be based on job-related factors.
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