Remote Prior Authorization & Surgical Scheduling Specialist
3 days ago
Edison
Who is Core Medical Wellness? Core Medical Wellness is redefining what meaningful healthcare feels like. We treat every person as a whole human being, not just a diagnosis. Our integrated, patient‑centered approach helps people move beyond pain and back to active, fulfilling lives. Role Summary We’re looking for a detail‑oriented Prior Authorization & Surgical Scheduling Specialist to own the process of securing insurance approvals and coordinating procedures for our pain management and regenerative medicine patients. This is a fully remote, part‑time role, Monday–Friday, with a consistent daytime schedule (approx. 15 - 20 hours per week). You’ll work closely with our clinical and front desk teams to: • Obtain timely prior authorizations and pre‑certifications, • Schedule procedures and coordinate with facilities, • Verify insurance eligibility and obtain prior authorizations for procedures, imaging, and treatments via payer portals and phone., • Review clinical documentation to determine authorization requirements., • Schedule procedures at various facilities and confirm logistics with patients., • Review patient deductibles/copays and document them in the EMR and tracking spreadsheets., • Track and appeal authorization denials when appropriate., • Answer questions from patients, internal staff, and insurance companies., • Maintain accurate, up‑to‑date records in our EMR and practice management systems., • 1+ year experience in prior authorizations, pre‑certs, or surgical scheduling (pain management, ortho, neuro, or similar preferred but not required)., • Strong knowledge of medical terminology, CPT/ICD‑10, and payer requirements (including Workers’ Comp / Auto)., • Proven ability to work independently, manage your own queue, and hit turnaround-time targets., • Excellent written and verbal communication., • Fully remote, part‑time role (Monday–Friday, consistent daytime hours)., • Competitive hourly pay starting at $23–$27/hour depending on experience and certifications., • Training on our workflows, EMR, and payer mix., • $23–$27 per hour for someone with 1–3+ years in prior auth / surgical scheduling, • You can reserve $26–$28+ for candidates with deep pain management / Workers Comp / Auto experience or who can own the entire pipeline with minimal supervision.