Prior Authorization Specialist (Contract)

Flagler Health is building the clinical operating system for modern musculoskeletal care.

We partner with MSK provider groups and specialty clinics to help them grow, operate more efficiently, and deliver better longitudinal care across patient acquisition, clinical workflows, and ongoing patient engagement. Our platform sits at the intersection of care delivery and clinic operations, helping providers capture more value across the full patient lifecycle.

We’ve recently raised our Series B and are entering our next phase of growth.

Role Overview

Flagler partners directly with pain management and orthopedic clinics to help optimize operations and improve financial performance. Prior authorizations are a critical component of that success.

We are seeking a Prior Authorization Specialist (Contract) to support high-volume authorizations for both procedures and prescription medications. This role focuses on provider/clinic-side workflows and requires someone who understands payer requirements, documentation standards, and how to proactively prevent downstream denials.

The ideal candidate is detail-oriented, experienced in complex authorizations, and comfortable working independently in a fast-paced environment.

What You’ll Be Doing

You will help ensure providers receive timely authorization approvals by managing the full lifecycle of prior authorization workflows.

Procedural Authorizations

Submit and manage prior authorizations for pain management and orthopedic procedures, including:

Epidural steroid injections

Facet injections

Radiofrequency ablation (RFA)

SI joint injections

Advanced imaging (MRI, CT)

Orthopedic surgical procedures

Prescription Drug Authorizations

Manage prior authorizations and reauthorizations for medications commonly used in pain management

Navigate pharmacy benefit portals and step-therapy requirements

Submit formulary exception and medical necessity documentation when required

Authorization Management

Navigate multiple payer portals efficiently

Verify insurance eligibility and benefits prior to submission

Review provider documentation to confirm medical necessity and procedural alignment

Follow up on pending or denied authorizations

Identify documentation gaps before submission to reduce preventable denials

Maintain clear documentation within EHR and tracking systems

Support billing and reconciliation activities as needed, including resolving authorization-related billing issues

This role requires strong workflow discipline, attention to detail, and the ability to manage a high volume of requests accurately.

Required Qualifications

3+ years of prior authorization experience in Pain Management or Orthopedics

Demonstrated experience with:

Interventional pain and/or orthopedic surgical authorizations

Prescription drug prior authorizations (medical and pharmacy benefit)

Experience working on the clinic/provider side (not hospital/facility billing)

Ability to independently manage high daily authorization volume

Hands-on experience with payer portals (e.g., Availity, UHC, Carelon/AIM, eviCore, Cohere, CoverMyMeds, etc.)

Strong working knowledge of CPT codes and procedural terminology

Experience reviewing documentation for medical necessity

Exceptional attention to detail and follow-through

Strongly Preferred

Experience with Medicaid plans, including AHCCCS

CPC-A or other coding certification

Familiarity with NCCI edits, bundling rules, and step therapy protocols

Experience identifying recurring denial patterns and process gaps

What Success Looks Like

Strong first-pass approval rates

Minimal preventable authorization-related denials

Consistent, timely submissions

Clear documentation and communication

Independent execution with limited supervision

Our Values:

This is what you can expect of your teammates at Flagler:

Owner: We own our work like founders. We don't wait to be asked, and we pick up the problem nobody else has.

Builder: We like making things from scratch. We don't need a playbook to start, and we'd rather ship a rough first version than wait on a perfect spec.

Fast: We make quick decisions. We favor progress and respect process.

Transparent: We communicate directly. We value merit and honesty, and we challenge assumptions, including our own.

Curious: We explore new approaches and ask "why" often.