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.
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.
You will help ensure providers receive timely authorization approvals by managing the full lifecycle of prior authorization workflows.
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
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
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.
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
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
Strong first-pass approval rates
Minimal preventable authorization-related denials
Consistent, timely submissions
Clear documentation and communication
Independent execution with limited supervision
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.
Job details are sourced from the employer's original posting.
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