Prior Authorization Specialist

Western Vascular Institute; Mesa (AZ); On-site; USD 48,000 - 64,000; Full time

Benefits offered by this job

401(k) with matching

Health, dental, vision, and life ins.

Disability insurance

Paid time off & paid sick time

Supportive and collaborative team

Job summary

Western Vascular Institute is seeking a Full-Time Prior Authorization Specialist to join our fast-paced vascular clinic. You will manage insurance authorizations for surgical procedures, imaging, and other services, while collaborating with physicians, staff, and patients to minimize delays in care.

Ideal candidates have 2+ years of prior authorization experience in a medical setting, strong insurance knowledge, and proficiency with EMR systems (NextGen preferred).

Qualifications

• 2+ years of prior authorization experience in a medical setting
• Strong understanding of medical terminology and insurance processes
• Knowledge of Medicare, Medicare Advantage, and commercial plans
• Experience with surgical authorizations or vascular services preferred
• Proficient with EMR systems and payer portals; NextGen experience preferred
• Excellent communication and interpersonal skills
• Strong organizational and multitasking abilities with attention to detail
• Ability to work independently or as part of a team
• Discretion with confidential patient information

Responsibilities

• Obtain, submit, and track prior authorizations for procedures and imaging
• Verify patient insurance eligibility, benefits, and coverage requirements
• Prepare and submit clinical documentation to meet payer requirements
• Monitor pending authorizations and follow up for timely approvals
• Coordinate peer-to-peer reviews, reconsiderations, and appeals as needed
• Communicate authorization statuses with physicians, staff, and patients
• Identify and resolve authorization barriers and missing documents
• Maintain accurate authorization records in EMR and payer portals
• Stay updated on changing payer guidelines and authorization requirements
• Prioritize requests based on procedure dates and patient needs
• Nurture relationships with physicians, staff, and insurance representatives

Skills

Prior Authorization

Medical terminology

Insurance verification

Communication skills

Organizational skills

Teamwork

Problem-solving

Attention to detail

Independence

Tools

EMR systems

NextGen

Job description

Western Vascular Institute is seeking a Full-Time Prior Authorization Specialist to join our busy and growing Vascular Clinic!

We’re looking for a hardworking, detail-oriented, and positive individual who thrives in a fast-paced medical environment. The ideal candidate will be a team player who enjoys collaborating with physicians, staff, insurance companies, and patients to ensure timely insurance authorizations and exceptional patient care.

Position Overview

As a Prior Authorization Specialist, you’ll be responsible for obtaining, managing, and tracking insurance authorizations for surgical procedures, in-office treatments, diagnostic imaging, and other specialty services. You’ll work closely with physicians, clinical staff, surgery schedulers, and insurance providers to ensure all necessary approvals are obtained accurately and efficiently, minimizing delays in patient care.

• Obtain, submit, and track prior authorizations for in-office and hospital-based surgical procedures, diagnostic imaging, and other medical services.


• Verify patient insurance eligibility, benefits, coverage requirements, and authorization guidelines.


• Prepare, submit, and maintain all necessary clinical documentation to meet insurance payer requirements.


• Monitor pending authorizations and follow up with insurance companies to ensure timely approvals.


• Coordinate peer-to-peer reviews, reconsiderations, and appeals for denied or delayed authorization requests.


• Communicate effectively with physicians, clinical staff, surgery schedulers, and patients regarding authorization statuses and requirements.


• Identify and resolve authorization barriers, including missing documentation, coverage limitations, and payer-related issues.


• Maintain accurate and up-to-date authorization records within the electronic medical record (EMR) system and insurance payer portals.


• Stay informed of changing insurance policies, authorization requirements, and payer guidelines.


• Prioritize authorization requests based on scheduled procedure dates and patient needs.


• Maintain excellent relationships with physicians, staff, insurance representatives, and management.

Qualifications & Skills

• 2+ years of prior authorization experience in a medical practice, surgery center, or hospital preferred.


• Strong understanding of medical terminology, insurance verification, and prior authorization processes.


• Knowledge of Medicare, Medicare Advantage, and commercial insurance plans.


• Experience with surgical authorizations, specialty procedures, or vascular services preferred.


• Proficient in computers, EMR systems, and insurance payer portals; NextGen experience preferred.


• Excellent communication and interpersonal skills.


• Strong organizational and multitasking abilities with keen attention to detail.


• Ability to problem-solve, prioritize deadlines, and work independently or as part of a team.


• Discretion and professionalism when handling confidential patient information.


• Positive attitude, flexibility, and a strong desire to learn.

We value candidates who demonstrate a strong work ethic, positive attitude, and eagerness to learn. While prior authorization experience is preferred, we are willing to provide additional training to the right candidate.

• 401(k) with matching


• Health, dental, vision, and life insurance


• Disability insurance


• Paid time off & paid sick time


• Supportive and collaborative team environment

Why Join Western Vascular Institute?

We’re looking for a long-term team member who wants to grow with us and contribute to our mission of providing exceptional vascular care. As a Prior Authorization Specialist, you’ll play an important role in helping patients receive timely access to necessary procedures and treatments while supporting our physicians and clinical team.

If you’re motivated, reliable, and ready to make a difference — we’d love to meet you!