Authorization Specialist

Overview

Integrated Pain Associates (IPA) is dedicated to changing the pain journey by treating each patient with an individualized care plan. We leverage specialized technology to deliver maximum effective results through minimally invasive pain management procedures. IPA is committed to providing a work environment that offers opportunity and growth in a progressive, exciting, fast-paced setting, with fairness, dignity, and respect.

Location:

Killeen, TX.

• Process all orders placed by IPA providers for patients across the pain management specialty from order to completion.
• Serve as liaison between providers, insurance carriers, and rendering care facilities.
• Act as primary point of contact for patients regarding orders.
• Respond to work correspondence in a courteous and professional manner.
• Utilize EMR system fax line, pull reports, and retrieve patient records for the department.
• Obtain prior authorization through insurance portals and external authorization departments based on provider orders; perform insurance verification.
• Review clinical documentation to ensure it supports insurance requirements for approval.
• Complete appeals and process Peer-to-Peer requests for denied procedures.
• Direct communications and concerns to the direct supervisor; copy appropriate recipients on emails and EMR encounters.
• Accurately notate accounts with actions related to prior authorizations, follow-ups, and scheduling.
• Respond accurately to staff inquiries related to the precertification department.
• Process all orders within a reasonable timeframe and monitor status for updates.
• Make and receive calls with patients and insurance companies within a reasonable time frame.
• Maintain high-priority tasks, messages, and emails daily.
• Format all authorization documents correctly and verify accuracy prior to submission.
• Notify appropriate departments in advance of potential issues regarding authorization submission.
• Additional tasks as assigned by Supervisor or Executive Management.

• Two (2) years of prior authorization experience.
• Experience processing outgoing referrals.
• Knowledge of CPT and ICD-10 codes.
• Ability to type at least 50 words per minute.
• Strong, professional communication skills and customer service orientation.
• Basic medical terminology; knowledge of HIPAA and Patient Rights guidelines.
• Ability to follow Federal, State, and Local regulations.
• Ability to enter data professionally into EMR systems (Glo EMR or equivalent).
• Ability to work 40 hours weekly; professional appearance; team-oriented; strong attendance.
• Bilingual is a plus.

• High school diploma or equivalent (preferred).
• Experience with CPT and ICD-10 coding (1 year preferred).
• Experience with ECW EMR system (1 year preferred).
• Experience with insurance eligibility and authorization portals (e.g., Availity, Carelon, Evicore) (1 year preferred).
• Specialty practice experience, preferably in pain management.
• Bilingual capabilities are a plus.

• Frequent sitting, writing, typing, and speaking.
• Occasional standing, walking, reaching, bending, lifting, and carrying up to 25 pounds.
• Frequent use of computer, keyboard, copy/fax machine, and phone.

• Three medical plans to choose from
• Two dental plans to choose from
• Vision plan
• Company-provided life and accidental death & dismemberment (AD&D) insurance; options to increase coverage for self and family
• Short-Term Disability
• Long-Term Disability
• Freshbenies (telemedicine, behavioral health, and medical bill auditing services)

Integrated Pain Associates is an Equal Opportunity Employer (EEO AA M/F/Vet/Disability). Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, protected veteran status, or disability.