Job Opportunities API

Submit prior authorization requests and secure approvals for pain procedures Verify patient insurance coverage, including coordination of benefits (COB), ensuring submissions are sent to the correct payor Review medical policies to identify insurance trends and ensure all submissions meet medical necessity criteria with correct CPT codes, levels, and laterality Maintain submission documentation and NAR (No Authorization Required) notifications in the patient's chart, including benefits and eligibility Compile and submit all relevant clinical documentation, including physical therapy and imaging reports, to insurance for approval Confirm insurance benefits and identify patient financial responsibility, including copays and coinsurance, during the PA process Update and monitor tracking systems (CRM) with authorization status and procedure details Schedule approved procedures Communicate with providers regarding discrepancies in orders and attend to provider emails promptly Review patient medical records to identify factors impacting procedure, specifically identifying if the patient is taking blood thinners during the PA process Review denial letters thoroughly and submit appeals when necessary to overturn insurance decisions Coordinate with internal departments on requests affecting authorizations or billing claims Follow U.S. HIPAA guidelines for Security and PHI