Top 57 Prior authorization specialist Jobs in Chandler Az

Eligibility, Referral and Authorization Specialist
CVAM, CardioVascular Associates of Mesa, P.C. —Mesa, AZ
- From $19 an hour
- Full-time
- HIPAA
- Mid-level
- In-person
- Health savings account
- Disability insurance
Quick Apply
Prior Authorization Specialist
Arizona Eye Specialists —Phoenix, AZ
- $20 - $23 an hour
- Full-time
- Background check
- Spanish
- Mid-level
- Health savings account
- Health insurance
Quick Apply
16h
Pharmacy Prior Authorization Specialist
Onco360 —Scottsdale, AZ
- From $23 an hour
- Full-time
- Customer service
- HIPAA
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
5d
Intake Specialist (In-Office if Local / Remote if Non-Local)
UNITED WOUND HEALING PS —Phoenix, AZ
- $19 - $23 an hour
- Overtime
- Microsoft Outlook
- Pass drug screening
- HIPAA
- AD&D insurance
- Paid holidays
Quick Apply
Patient Access Lead
Optum —Chandler, AZ
- $20 - $36 an hour
- 8 hour shift
- 18 years or older
- Basic math
- Pass drug screening
- On-the-job training
12h
Botox Prior Authorization Specialist
Foothills Neurology P C —Phoenix, AZ
- Medical office experience
- Research
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Pharmacy Tech Specialist- OP Prior Authorization Tech
Phoenix Children's Hospital —Phoenix, AZ
- Full-time
- Mid-level
- Outpatient experience
- Cash register
Specialist Patient Access
Dignity Health Medical Group —Phoenix, AZ
- $19.01 - $26.85 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Travel
12d
Insurance Verification Specialist - Specialty Pharmacy
AssistRx —Tempe, AZ
- $39,520 - $45,760 a year
- Full-time
- Hybrid work
- Background check
- Mid-level
- Analysis skills
- Disability insurance
- Health insurance
Quick Apply
Eligibility and Benefits Specialist
Oshi Health —Phoenix, AZ
- $47,000 - $52,000 a year
- Email
- Remote
- HIPAA
- Research
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
11d
Patient Access Liaison- Phoenix, AZ
Amgen —Phoenix, AZ
- $158,394 - $222,256 a year
- Weekends as needed
- Doctoral degree
- Up to 50% travel
- HIPAA
- Disability insurance
- Health insurance
1d
Medical Billing Specialist - Outpatient Behavioral Health
Bella Vida TMS —Gilbert, AZ
- $20 - $25 an hour
- Full-time
- Medical office experience
- Administrative experience
- Clinic
- Health insurance
- Dental insurance
Quick Apply
2d
Patient Access Specialist - Specialty Pharmacy
AssistRx —Phoenix, AZ
- $40,000 - $50,000 a year
- Full-time
- Background check
- Mid-level
- Analysis skills
- Paid holidays
- Disability insurance
Quick Apply
Referral Specialist
TriWest Healthcare Alliance —Phoenix, AZ
- $40,000 - $45,000 a year
- Overtime
- Microsoft Outlook
- Computer literacy
- HIPAA
- AD&D insurance
- Disability insurance
13d
Therapy Care Specialist - Acute Infusion Pharmacy Technician
Soleo Health Inc —Tempe, AZ
- Urgently hiring
- Microsoft Word
- Microsoft Outlook
- Mid-level
- Paid parental leave
- Health savings account
Quick Apply
6d
Full Cycle Biller - Workers' Compensation Specialist
Spooner —Scottsdale, AZ
- $21 - $23 an hour
- High school diploma or GED
- In-person
- 2 years
- Paid holidays
- Loan repayment program
Quick Apply
EDI Analyst
American Vision Partners —Phoenix, AZ
- Full-time
- Computer science
- Microsoft Outlook
- Surgery
- Paid holidays
- Health insurance
Front Desk Medical Receptionist
Skin Care Specialists —Scottsdale, AZ
- $17 - $18 an hour
- Full-time
- Mid-level
- Organizational skills
- In-person
- Health insurance
- Dental insurance
Quick Apply
13h
Medical Insurance Verification Specialist
Desert Bloom Family Medicine —Phoenix, AZ
- $18 - $20 an hour
- Full-time
- Bilingual
- Customer service
- Medical office experience
- Health insurance
- Dental insurance
Quick Apply
Data Entry & Medical Records Specialist
State of Arizona —Phoenix, AZ
- $16.11 an hour
- Full-time
- Background check
- Microsoft Excel
- Computer literacy
- Paid parental leave
- Paid holidays
12d

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Eligibility, Referral and Authorization Specialist

CVAM, CardioVascular Associates of Mesa, P.C. -
Mesa, AZ

Quick Apply

Job Details

Full-time
From $19 an hour

Benefits

Health savings account
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Customer communication
Medical documentation
Medicare
HIPAA
Filing
Scanning

Full Job Description

Are you a caring individual looking for a place where your expertise will be valued, your knowledge expanded, and your abilities challenged? CVAM is a place where employees know they are part of something bigger than themselves, take exceptional pride in their work, and are committed to continuous growth and excellence. This opportunity allows you to collaborate with an exceptional team, contribute to our shared success, and focus on what matters most—our patients.

CVAM offers a comprehensive benefits package designed to provide peace of mind both in and out of the workplace. We are committed to supporting our employees with competitive health benefits, paid time off, continuing education opportunities, retirement planning, and resources that help meet personal and family needs now and in the future.

Job Overview: The Eligibility, Referral, and Authorization Specialist verifies insurance eligibility and benefits, obtains and manages prior authorizations for in-office testing, and coordinates primary care referrals to ensure patients are appropriately cleared for services while supporting efficient clinical operations and revenue cycle performance.

The shift schedule is 7:30am-3:30pm Monday through Friday.

RESPONSIBILITIES:

Review appointment schedules daily for the current date through five (5) business days in advance, including same-day add-on appointments, to identify referral, authorization, and eligibility requirements. Review appointments scheduled up to two (2) weeks in advance for in-office testing requiring prior authorization (including ultrasound, nuclear stress testing, PET, Holter monitoring, and wireless telemetry).
Obtain required referrals and prior authorizations by contacting referring providers, primary care providers (PCPs), and health plans as appropriate.
Contact patients to obtain or verify insurance information as needed.
Verify patient eligibility, benefits, and coverage prior to scheduled services.
Update patient accounts with accurate demographic, insurance, and other required information.
Ensure all required referrals and authorizations are obtained and patient eligibility is verified prior to the scheduled appointment.
Scan or save referral, authorization, and insurance-related documentation as PDF files and upload them to the patient's electronic medical record (EMR) or ezAccess, as appropriate.
Coordinate peer-to-peer reviews between providers and insurance carriers when required and prepare or submit written appeals when appropriate.
Notify the Front Office Manager no later than forty-eight (48) hours prior to a scheduled appointment when a required referral or authorization has not been obtained.
Respond promptly to telephone calls, Microsoft Teams messages, and inquiries from patients and CVAM staff regarding referrals, eligibility, and authorizations.
Create and update referral and authorization cases within the practice management system, ensuring accurate documentation for each date of service prior to claim submission.
Assist the billing department with questions related to claims, referrals, authorizations, post-service insurance corrections, retroactive authorization requests, and referral issues.
Monitor the EMR desktop, email, and other assigned communication channels daily, responding to referral receipts and internal communications within twenty-four (24) hours.
Notify the ERA Lead of barriers or delays in obtaining referrals or authorizations from insurance carriers or provider offices.
Collaborate with the ERA Lead to resolve complex referral and authorization issues involving primary care or referring provider offices.
Communicate changes in insurance carrier or provider office referral and authorization requirements to the ERA Lead.
Participate in educating clinic staff regarding referral, authorization, and eligibility processes as they relate to their job responsibilities.
Demonstrate excellent written and verbal communication skills while providing exceptional customer service to internal and external customers.
Maintain professionalism and composure while effectively managing multiple priorities in a fast-paced environment.
Document all patient interactions and insurance-related activities accurately, thoroughly, and promptly within the patient's medical record.
Maintain strict confidentiality and comply with all HIPAA and organizational privacy requirements.
Complete all required new hire, annual, and ongoing education and training as a condition of employment.
Perform other duties as assigned.

GOALS AND OBJECTIVES

Verify patient eligibility, benefits, and insurance information and update the patient record at least five (5) business days prior to the scheduled appointment, or immediately upon notification for STAT, urgent, or same-day add-on appointments.
Maintain referral, authorization, and eligibility work queues to ensure appointments scheduled at least five (5) business days in advance are reviewed and processed in a timely manner.
Ensure all required referrals and authorizations are obtained and documented for all current-day appointments and appointments scheduled for the following business day.
Minimize appointment delays, cancellations, and rescheduling due to missing referrals, authorizations, or eligibility issues.
Meet departmental productivity and quality standards by accurately processing referrals and authorizations while maintaining complete and timely documentation.
Maintain effective communication with patients, providers, insurance carriers, and internal departments to facilitate timely resolution of referral and authorization issues.
Escalate unresolved referral, authorization, or payer issues to the ERA Lead in a timely manner to support continuity of patient care and revenue cycle performance.

Pay: From $19.00 per hour

Benefits:

401(k)
401(k) matching
Dental insurance
Disability insurance
Health insurance
Health savings account
Life insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

prior authorization specialist jobs in chandler az

Eligibility, Referral and Authorization Specialist

Prior Authorization Specialist

Pharmacy Prior Authorization Specialist

Intake Specialist (In-Office if Local / Remote if Non-Local)

Patient Access Lead

Botox Prior Authorization Specialist

Pharmacy Tech Specialist- OP Prior Authorization Tech

Specialist Patient Access

Insurance Verification Specialist - Specialty Pharmacy

Eligibility and Benefits Specialist

Patient Access Liaison- Phoenix, AZ

Medical Billing Specialist - Outpatient Behavioral Health

Patient Access Specialist - Specialty Pharmacy

Referral Specialist

Therapy Care Specialist - Acute Infusion Pharmacy Technician

Full Cycle Biller - Workers' Compensation Specialist

EDI Analyst

Front Desk Medical Receptionist

Medical Insurance Verification Specialist

Data Entry & Medical Records Specialist

I want to receive the latest job alert for prior authorization specialist in chandler az

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