Prior Authorization & Procedure Scheduling Coordinator

We are seeking a highly organized, proactive, and detail-oriented Prior Authorization & Procedure Scheduling Coordinator to support a fast-paced interventional pain management practice. This position is responsible for coordinating the entire procedure scheduling process—from obtaining insurance authorization through scheduling the patient, facility, anesthesia, and necessary vendors.

The ideal candidate is an excellent communicator who can manage multiple cases simultaneously, follow up consistently, and ensure procedures move efficiently from physician order to completion.

Key Responsibilities

Prior Authorizations

• Obtain prior authorizations for interventional pain management procedures.
• Verify insurance benefits, eligibility, authorization requirements, and procedure coverage.
• Submit clinical documentation, procedure codes, diagnosis codes, and supporting records to insurance carriers.
• Track pending authorizations and follow up consistently until a determination is received.
• Communicate authorization approvals, denials, and additional documentation requirements to the appropriate clinical team.
• Assist with coordinating peer-to-peer reviews and appeals when necessary.
• Maintain accurate documentation of authorization status in the EMR/practice management system.
• Identify authorization issues early to prevent unnecessary procedure delays or cancellations.

Procedure Scheduling

• Schedule pain management procedures ordered by providers, including injections, ablations, spinal cord stimulator procedures, peripheral nerve stimulation procedures, and other interventional procedures.
• Contact patients promptly to coordinate procedure dates and provide scheduling information.
• Ensure all necessary authorization and documentation requirements are completed prior to the procedure.
• Maintain and manage physician procedure schedules to maximize efficiency and appropriate utilization.
• Monitor upcoming procedures and proactively resolve scheduling conflicts or outstanding requirements.

Facility Coordination

• Coordinate procedure scheduling with hospitals, ambulatory surgery centers, and other facilities.
• Submit required scheduling forms, orders, authorizations, demographics, insurance information, and supporting documentation.
• Confirm procedure dates, times, locations, and facility requirements.
• Maintain strong communication with facility scheduling departments to prevent delays or missing information.

Anesthesia Coordination

• Coordinate anesthesia coverage for procedures when required.
• Communicate procedure schedules and any changes with anesthesia teams.
• Confirm anesthesia availability prior to finalizing applicable cases.
• Ensure required patient and procedure information is provided to the anesthesia team.

Vendor Coordination

• Coordinate with medical device representatives and vendors for procedures requiring specialized equipment or support.
• Notify representatives of scheduled cases and confirm their availability.
• Ensure appropriate equipment, implants, supplies, and representatives are available for the scheduled procedure.
• Communicate schedule changes or cancellations promptly.

Patient Communication

• Provide patients with clear information regarding procedure date, time, location, and required preparation.
• Communicate insurance authorization status when appropriate.
• Answer scheduling questions and help patients navigate the procedure process.
• Reschedule canceled or postponed procedures promptly.
• Maintain professional and compassionate communication with patients throughout the scheduling process.

Daily Expectations

The coordinator should maintain an organized and up-to-date procedure pipeline that clearly identifies:

• Procedures awaiting authorization
• Authorizations pending additional information
• Approved procedures awaiting scheduling
• Scheduled procedures
• Cases requiring anesthesia
• Cases requiring vendor coordination
• Cases requiring facility follow-up
• Denied cases requiring additional action
• Canceled or rescheduled procedures requiring follow-up

Requirements

Qualifications

• Previous experience with medical prior authorizations and procedure scheduling strongly preferred.
• Experience in pain management, orthopedics, neurosurgery, spine, surgery, or another procedure-heavy specialty is highly desirable.
• Knowledge of commercial insurance, Medicare, and managed-care authorization processes.
• Familiarity with CPT and ICD-10 codes.
• Experience communicating with insurance companies, hospitals, ASCs, anesthesia groups, and medical device representatives.
• Strong computer and EMR/practice management skills.
• Excellent organizational and multitasking abilities.
• Strong written and verbal communication skills.
• Ability to work independently and follow through without constant supervision.
• Comfortable working in a high-volume, fast-paced clinical environment.

Ideal Candidate

We are looking for someone who is persistent, organized, accountable, and proactive. This individual should understand that successful procedure scheduling involves much more than placing a patient on a calendar. They must actively manage each case from authorization through procedure completion and coordinate all parties involved.

The right person will anticipate problems, follow up without being asked, communicate effectively with the clinical team, and take ownership of ensuring that patients' procedures move forward efficiently.

Key Performance Expectations

Success in this role will be measured by:

• Timely submission of prior authorizations
• Consistent follow-up on pending cases
• Reduced authorization-related cancellations
• Timely scheduling of approved procedures
• Accuracy of procedure schedules
• Effective coordination with facilities, anesthesia, and vendors
• Prompt patient communication
• Accurate documentation
• Minimal cases left without follow-up or a defined next action
• Ability to maintain an efficient procedure pipeline in a busy pain management practice