Prior Authorization Specialist I (Hybrid)

Arizona Priority Care; Chandler (AZ); Hybrid; USD 28,000 - 32,000; Full time

Job summary

Arizona Priority Care in Chandler, AZ is hiring a Prior Authorization Representative I to process incoming requests, verify eligibility and benefits, and enter data for prior authorization requests. The role requires coordination with UM staff, supervisors, physicians, and office staff to meet turnaround targets and regulatory requirements.

You will perform data entry with accuracy, determine if services require prior authorization, and educate providers on the authorization process.

Qualifications

• High school diploma or GED is required.
• Minimum of 1 year administrative healthcare related experience is required.
• Proficient knowledge of medical terminology (CPT-4, HCPCS, ICD-10).
• Strong communication skills and ability to multi-task.

Responsibilities

• Process incoming prior authorization requests and verify eligibility and benefits.
• Enter data for prior authorization requests with high accuracy.
• Review and route requests, identify urgent vs routine, and ensure timely processing.
• Communicate with providers and office staff to obtain necessary information.

Skills

Healthcare admin

Medical terminology

MS Office

Communication skills

Detail-oriented

Team interaction

Education

Highschool Diploma or GED

Tools

Microsoft Office

Job description

Arizona Priority Care in Chandler, AZ is hiring a Prior Authorization Representative I to process incoming requests, verify eligibility and benefits, and enter data for prior authorization requests. The role requires coordination with UM staff, supervisors, physicians, and office staff to meet turnaround targets and regulatory requirements.

You will perform data entry with accuracy, determine if services require prior authorization, and educate providers on the authorization process.