Prior Auth & Insurance Ops Leader

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 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.