Preauthorization Specialist

North Florida Surgeons, P.A.•Fort Walton Beach, FL

About The Position

Join our busy, patient-focused orthopedic, spine, and pain management, dedicated to delivering high-quality care and improving patient outcomes. We value teamwork, clear communication, efficiency, and accountability. We’re seeking a detail-oriented Preauthorization Specialist to obtain and manage insurance authorizations for surgeries, interventional pain procedures, injections, imaging, EMG/NCS, physical therapy, and durable medical equipment. You’ll work closely with providers, schedulers, and billing to ensure timely care and minimize denials.

Requirements

High school diploma or GED required
1+ years’ experience in prior authorizations, insurance verification, utilization review, or medical billing
Familiarity with payer portals, EMRs (e.g., Athena, Availity Humana Military, etc), and CPT/ICD-10 basics.
Strong communication, organization, and multitasking skills.
Professional phone etiquette and ability to work under deadlines.

Nice To Haves

healthcare-related certificate or associate degree preferred
experience in orthopedics, spine, or pain management preferred
Bilingual skills a plus (specify language if applicable)

Responsibilities

Obtain prior authorizations and notifications from commercial payers, Medicare, and Medicaid.
Review clinical documentation and submit authorization requests per payer requirements.
Verify pre-service requirements.
Track and update authorization status in the EMR and practice management system.
Communicate authorization status to facilities and staff.
Collect and submit supporting clinical documentation; follow up on pending requests.
Prepare and coordinate appeals and peer-to-peer reviews for denials.
Maintain accurate, auditable records and suggest process improvements.