Insurance and Prior Authorization Manager

Vein Clinics of America, Inc.; Northbrook (IL); On-site; USD 70,000 - 85,000; Full time

Benefits offered by this job

Health

Dental

Vision

PTO

401(k)

Job summary

USA Clinics Group is seeking an Insurance and Prior Authorization Manager to lead the authorization and related revenue-cycle activities in Northbrook, IL. This on-site role oversees clinical documentation improvement specialists and clerical staff, aligning with physicians and senior leadership to ensure timely authorizations and accurate eligibility checks.

Responsibilities include coaching staff, monitoring productivity, automating processes, and coordinating with billing to resolve denials.

Qualifications

• High school diploma or equivalent required.
• Bachelor’s degree in health information administration preferred.
• 3 years medical authorization experience required.
• 2+ years in a leadership role required.
• Active knowledge of CMS guidelines, contracted insurance guidelines, and coding policies.
• Strong background in Revenue Cycle Management preferred.
• Excellent verbal and written communication skills.
• Detail oriented, reliable, and able to multi‑task in a fast‑paced environment.
• Demonstrated computer literacy and math skills.
• Maintain confidentiality and professionalism.

Responsibilities

• Monitor productivity and performance of staff with department metrics for Senior Leadership.
• Provide regular performance feedback and encourage two‑way communication.
• Coach staff and develop action plans for improvement.
• Monitor Prior Authorization and Eligibility automation processes.
• Assist IT in developing new automation for authorization submission and insurance verification.
• Collaborate with billing on claim denials related to authorization and eligibility.
• Produce productivity and error reports to assess staff performance.
• Prioritize work to maximize turnaround time.
• Contact insurance plans to determine eligibility and obtain coverage and benefits.
• Obtain prior authorization for services from plans and document findings thoroughly.

Skills

Leadership

Communication

Confidentiality

Detail oriented

Multi-tasking

Education

High school diploma or equivalent

Bachelor’s degree in health information administration

Job description

USA Clinics Group is looking for an Insurance and Prior Authorization Manager to join our team. The Insurance and Prior Authorization Manager will collaborate with physicians, SVP of Revenue Cycle, and other members of the management team. They will serve as a critical link between providers, payers, and patients; and will directly oversee and manage the following employees:

• Clinical documentation improvement specialists
• Administrative staff and clerks

Position Details

• Location: Northbrook, IL
• Schedule: Full-Time, Monday‑Friday (on‑site)
• Compensation: $70,000-$85,000 based on experience and qualifications.

Responsibilities

• Monitor and manage productivity and performance of assigned employees including daily/weekly/monthly department metrics to Senior Leadership and provide reporting and action plans for improvement.
• Maintain positive leadership and give frequent performance feedback, encouraging two‑way communication.
• Coach employees when needs are identified, holding them accountable through coaching and development of action plans.
• Monitor Prior Authorization and Eligibility automation processes.
• Assist IT team in developing new automation processes for authorization submission/tracking and insurance verification.
• Work closely with billing team for claim denials related to authorization and eligibility.
• Produce productivity and error reports to assess staff performance.
• Prioritize work to maximize turn‑around time.
• Contact insurance plans to determine eligibility and obtain coverage and benefit information.
• Contact insurance plans to obtain prior authorization for services.
• Document findings thoroughly and accurately.
• Perform training with organizational staff on procedures for requesting, documenting, and processing prior authorizations.
• Complete additional duties as assigned.

Qualifications

• High school diploma or equivalent (required).
• Bachelor’s degree with specialization in health information administration (preferred).
• 3 years medical authorization experience (required).
• Strong background and experience in Revenue Cycle Management (preferred).
• 2+ years in a leadership role (required).
• Active knowledge of CMS guidelines, contracted insurance guidelines, and coding policies.
• Ability to lead a team by demonstrating a positive attitude, openness to change, willingness to help, and respect for others and their ideas.
• Excellent verbal and written communication skills.
• Detail oriented, reliable, and able to multi‑task in a fast‑paced, high‑volume work environment.
• Demonstrated computer literacy and excellent math skills.
• Ability to maintain a high level of confidentiality and professionalism.

Benefits

• Health
• Dental
• Vision
• PTO
• 401(k)