Insurance Specialist (Prior Authorization Coordinator)

Job Description

Job Description

Description:

The Prior Authorization Coordinator supports the day-to-day operations of our revenue cycle and administrative team. Under the direction of the Admin Manager, this role plays a key part in ensuring timely prior authorizations, verifying coverage, auditing workflows, and contributing to process improvements. This position is ideal for a proactive, detail-oriented individual who thrives in a collaborative, non-patient-facing environment and is passionate about operational excellence, team success, and maximizing reimbursement efficiency.

• Obtain Insurance Authorizations – Secure timely prior authorizations for procedures, diagnostics, and medications to prevent delays and denials.
• Verify Patient Insurance Coverage – Confirm eligibility, benefits, and authorization requirements prior to services.
• Communicate with Insurance Providers – Proactively follow up on pending requests, resolve issues, and clarify payer guidelines.
• Maintain Accurate Authorization Documentation – Record and track authorization requests, approvals, denials, peer-to-peers, and appeals in the practice management system.
• Coordinate Patient & Clinical Communication – Educate patients on authorization requirements and collaborate with clinical staff to ensure timely service delivery.
• Schedule & Coordinate Peer-to-Peer Reviews – Arrange and track peer-to-peer discussions with insurance medical reviewers as needed.
• Provide Cross-Coverage for FC/MR – Support Front Office (FC) and Medical Records (MR) functions as required.
• Prepare Weekly/Monthly Authorization Reports – Conduct audits and generate reports including impressions and authorization metrics.

• High school diploma or equivalent
• 3+ years of experience in medical prior authorizations, medical billing, or revenue cycle
• Knowledge of insurance plans (Medicare and Commercial)
• Strong attention to detail and organizational skills
• Excellent written and verbal communication skills
• Proficiency in EMR/EHR and practice management systems

• Experience in DME and sleep medicine
• Experience working with high-volume authorization requests

Skills & Competencies

• Strong follow-up and time management skills
• Ability to work independently and meet deadlines
• Problem-solving and critical thinking abilities
• Ability to manage multiple tasks with accuracy
• Customer service mindset when working with patients and payers

• Competitive salary and benefits package.
• Professional development opportunities and continuous learning.
• Innovative and supportive work environment focused on patient-centered care.

About North American Dental Sleep Management:

North American Dental Sleep Management (NADSM) is an administrative and management services organization dedicated to supporting a growing network of Dental and Sleep Medicine PLLCs across the country. We partner with dental and sleep medicine providers to deliver the operational infrastructure, administrative expertise, and management support they need to focus on what matters most — providing exceptional patient care.

Our team works behind the scenes to ensure the practices we support run efficiently and effectively, handling the complexities of day-to-day operations so that clinicians can dedicate their time and energy to their patients. NADSM serves as the backbone of a dynamic and expanding group of practices at the intersection of two rapidly growing fields — dental care and sleep medicine.

At NADSM, we are building something meaningful. We believe that when the right administrative and operational support is in place, providers can do their best work and patients experience better outcomes. If you are someone who thrives in a fast-paced, collaborative environment and wants to be part of a company that is growing with purpose, we would love to have you on our team.

If you are passionate about improving sleep health and are looking for an opportunity to grow in a specialized medical field, we encourage you to apply!