Prior Authorization Specialist — Streamlining Patient Access

Phoenixheart; Glendale (AZ); On-site; USD 38,000 - 54,000; Full time

Job summary

Phoenixheart in Arizona is seeking an Authorization Coordinator to manage prior authorizations for diagnostic tests, verify eligibility and benefits, and ensure medical necessity requirements are met before patient appointments. The role includes reviewing schedules, contacting physicians and health plans, updating EMR with authorization data, and supporting billing with eligibility questions.

Strong attention to detail and the ability to work calmly under pressure are essential.

Qualifications

• 2+ years of related experience and/or training.
• In-depth knowledge and understanding of medical health insurance.
• Cardiology knowledge preferred, but not required.
• Must have Diagnostic Authorization testing experience.
• Ability to stay calm and professional in stressful situations while ensuring customer satisfaction.
• Professional attitude and reliability.
• Ability to solve problems, prioritize and multitask in a deadline-driven environment.
• Ability to make independent decisions with minimal supervision.
• Willingness to work outside core business hours as needed.
• Able to work in a team environment with positive interactions.
• Strong time management and organizational skills.
• Excellent interpersonal, verbal and written communication skills.
• Keen attention to detail and ability to handle confidential information.
• Proficient with PC-based software programs.

Responsibilities

• Review daily appointment schedule for today through five days out and coordinate authorizations/referrals.
• Verify patient eligibility and benefits.
• Contact referring physicians, PCPs or health plans for paper referrals and authorizations.
• Contact patients for insurance verification when needed.
• Handle calls about referrals/authorizations from check-in or patients.
• Update patient accounts with authorization-related information.
• Add referrals/authorization data to dates of service before claim filing.
• Assist billing with eligibility and authorization questions.
• Review EMR, email, fax and interoffice communications daily; respond within 24 hours.
• Inform manager of difficulties obtaining authorizations or referrals.
• Inform about insurance changes affecting authorizations/referrals.
• Participate in referral/authorization training for clinic staff.
• Notify Front Office if authorization/referral not received before visit.
• Review add-ons for the next day before leaving.
• Scan referrals and authorization documents into patient charts.
• Document concisely in patient charts.
• Participate in new hire/annual training.
• Perform other assigned tasks.

Skills

Medical insurance knowledge

Attention to detail

Customer service

Communication skills

Time management

Organizational skills

Teamwork

Problem solving

Multitasking

Confidentiality

PC proficiency

Education

High school diploma or equivalent

Tools

EMR systems

Job description

Phoenixheart in Arizona is seeking an Authorization Coordinator to manage prior authorizations for diagnostic tests, verify eligibility and benefits, and ensure medical necessity requirements are met before patient appointments. The role includes reviewing schedules, contacting physicians and health plans, updating EMR with authorization data, and supporting billing with eligibility questions.

Strong attention to detail and the ability to work calmly under pressure are essential.