Prior Authorization Specialist

Foothills Neurology; Phoenix (AZ); On-site; USD 38,000 - 52,000; Full time

Job summary

Foothills Neurology is seeking a Prior Authorization Specialist to manage authorizations and referrals in a high-volume environment. You will ensure timely processing, review records, and communicate with providers, patients, and staff to maintain compliance.

Ideal candidates have 3+ years of relevant experience, strong organizational skills, and proficiency with Athena EMR. The role emphasizes accuracy, HIPAA compliance, and collaboration within the billing workflow.

Qualifications

• High School Diploma or GED required.
• 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 EMR is required.

Responsibilities

• Process prior authorizations for medications, referrals, and in-house procedures.
• Review and obtain referrals and authorizations for office visits.
• Manage the daily inbox and ensure 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 for accuracy and compliance.

Skills

Multitasking

Organization

Communication

Problem-solving

Discretion

Teamwork

Education

High School Diploma or GED

Tools

Athena

Job description

Job Description

Job 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.

Company Description

Foothills Neurology is a private practice offering a full range of neurologic specialties ready to provide comprehensive and compassionate care

As we work together to put the needs of the patient first, we are also dedicated to our employees, providing benefit plans to take care of you and your family, now and in the future. You can thrive in an environment that is fun and provides the resources you need to succeed.

Company Description

Foothills Neurology is a private practice offering a full range of neurologic specialties ready to provide comprehensive and compassionate care
As we work together to put the needs of the patient first, we are also dedicated to our employees, providing benefit plans to take care of you and your family, now and in the future. You can thrive in an environment that is fun and provides the resources you need to succeed.