Prior Authorization Specialist
Job Description
Job Description
Description:
Summary:
The Prior Authorization Specialist will handle all aspects of prior authorizations and referrals, ensuring timely and accurate processing. This role requires a detail-oriented individual who thrives in a high-volume environment and can manage multiple priorities at once.
Job Description:
Authorization Responsibilities
- Process prior authorizations for medications, specialist referrals, and/or in-house procedures.
- Review and Obtain Referrals and or Authorizations for Office visits
- Manage the daily inbox, ensuring documents are processed promptly.
- Review medical records to confirm insurance requirements are met.
- Submit requests to insurance companies and follow up until completion.
- Follow payer guidelines, HIPAA, and internal policies
- Communicate approval/denial updates to providers, patients, and staff.
- Maintain organized records of all authorization activities.
- Perform basic quality checks on work completed by the team
- Identify process gaps and communicate improvement opportunities
- Collaborate with providers, clinical staff, and billing to ensure accuracy and compliance.
Required Education:
- High School Diploma or GED
Required Experience:
- Minimum 3 years of experience in prior authorizations, referrals, or a related medical office role.
- Knowledge of insurance processes and medical terminology required.
- Experience with Athena required.
Requested Qualifications/Skills:
- Ability to perform efficiently and juggle multiple priorities in a fast-paced, high-volume environment.
- Strong multitasking and organizational skills.
- Strong communication, interpersonal, and problem-solving skills.
- Ability to handle confidential information with discretion and professionalism.
- Team collaboration skills.
Recommended Jobs
Material Handler
Job Description Job Description The position will perform shipping, receiving and non-technical inspections of parts and components entering or leaving the warehouse. Responsibilities: Resp…
Experienced Orthodontic Assistant at Garn Mason Orthodontics - Specialty Dental Brands - Chandler, Arizona, United States
Full-time Description Our office is looking for a fun, energetic back-office team member. Patient care and experience are very important to our office. We value an individual who exhibits …
Armed Transportation Officer - Tucson, AZ
Asset Protection & Security Services, a 30-year company, with 24 years of those years specializing in detention and transportation, is looking for people to be part of our team. If you meet the requi…
Line Cook
For this position, pay will be variable by location - See additional job details and benefits below. Our Winning Family Starts With You! Check out these great benefits! ~ Flexible sche…
RN Labor & Delivery
Job Description Job Description Job Summary RN Labor & Delivery Talented Medical Solutions Contract In-Office | Ganado, AZ, United States The Opportunity The L&D RN provides c…
Now Hiring: Back-Office / Onboarding Assistant - Trucking Industry ($1,600-$2,000/week | Remote U.S.)
Now Hiring: Back-Office / Onboarding Assistant – Trucking Industry ($1,600–$2,000/week | Remote U.S.) We're looking for a Back-Office / Onboarding Assistant with experience in trucking, dispatch…
Client Services Representative
Customer Service Representative (CSR) Company: Sahuaro Vista Veterinary Clinic Location: Tucson/Oro Valley, AZ Job Type: Full-Time / Part-Time Experience: Previous veterinary or medica…
*Clinical Maternal-Fetal Medicine (MFM) Physician - Tucson, AZ
Maternal-Fetal Medicine Physician | Banner University Medical Center Tucson/University of Arizona Tucson Banner University Medical Center Tucson (BUMC-T) and the Department of Obstetrics and Gy…
Draftsperson
Job Description Job Description Position Description: Summary/Objective: Reporting to a member of the project Management team, the incumbent will be responsible for the production Architectura…
Commercial Construction Project Manager
Job Description Job Description Commercial Construction Project Manager Phoenix, AZ | Local Projects Only Base Salary: $115,000 – $135,000 + Bonus & Strong Benefits Join a commercial c…