Prior Authorization Specialist - Payer Policies & Billing

GI Alliance; Glendale (AZ); On-site; USD 42,000 - 60,000; Full time

Job summary

Academic Urology & Urogynecology of Arizona is seeking a detail-oriented Authorization Specialist to review EMR messages, scheduling, and medical policy guidelines, ensuring timely approvals for upcoming surgical and in-office procedures.

You will verify coverage, obtain authorizations via payer portals or phone, follow up on pending cases, and communicate out-of-pocket obligations with patients, supporting efficient, compliant billing in a fast-paced environment.

Qualifications

• Minimum 1 year prior authorization experience.
• Understanding of payer medical policy guidelines to manage authorizations effectively.
• Proficient use of CPT and ICD10 codes.
• Detail-oriented and above-average organizational skills.
• Plans and prioritizes to meet deadlines.
• Ability to multitask and remain focused while managing a high volume, time-sensitive workload.
• Urology experience helpful.

Responsibilities

• Review EMR chart messaging and review schedules daily for upcoming surgical and in-office procedures.
• Review chart documentations to ensure patient meets medical policy guidelines.
• Prioritize authorization requests according to urgency.
• Obtain authorization via payer website or by phone and follow up regularly on pending cases.
• Verify coverage and benefits and calculate any out-of-pocket portions due.
• Contact patients to review any out-of-pocket portions due prior to surgery.

Skills

Prior authorization experience

Detail-oriented

Multitasking

Strong communication skills

Tools

CPT codes

ICD-10 codes

Job description

Academic Urology & Urogynecology of Arizona is seeking a detail-oriented Authorization Specialist to review EMR messages, scheduling, and medical policy guidelines, ensuring timely approvals for upcoming surgical and in-office procedures.

You will verify coverage, obtain authorizations via payer portals or phone, follow up on pending cases, and communicate out-of-pocket obligations with patients, supporting efficient, compliant billing in a fast-paced environment.