Top 317 Prior authorization Jobs in Phoenix Az

Prior Authorization Representative I
Arizona Priority Care —Chandler, AZ
- $20 - $23 an hour
- Full-time
- Hybrid work
- Office
- Administrative experience
- High school diploma or GED
Unit Support Associate
Phoenix Children's Hospital —Phoenix, AZ
- Part-time
- HIPAA
- Clinic
- Children
Representative - Admissions Services
HonorHealth —Phoenix, AZ
- Night shift
- Hospital
- HIPAA
- High school diploma or GED
Administrative Assistant
LifeHealth LLC —Phoenix, AZ
- $34.63 an hour
- Full-time
- Military
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
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
Case Manager - Phoenix, AZ
Insmed Incorporated —Phoenix, AZ
- $39 - $50 an hour
- Full-time
- Remote
- HIPAA
- Mid-level
- Bachelor's degree
- Employee stock purchase plan
- Disability insurance
ER Registration Admitting
HonorHealth —Phoenix, AZ
- Part-time
- HIPAA
- High school diploma or GED
- ER
Prior Authorization Specialist
Foothills Neurology P C —Phoenix, AZ
- $20 - $25 an hour
- Medical office experience
- HIPAA
- Mid-level
Quick Apply
Medical Assistant
Az Asthma & Allergy Institute —Scottsdale, AZ
- Full-time
- Patient monitoring
- Inventory management
- Mid-level
Medical Assistant
GARDAWORLD FEDERAL SERVICES LLC —Surprise, AZ
- $22.16 an hour
- Weekends as needed
- Background check
- Vital signs
- Writing skills
Quick Apply
Medical Assistant (Gilbert)
Enticare PC —Gilbert, AZ
- $20 - $24 an hour
- 8 hour shift
- Spanish
- Vital signs
- Inventory management
- Health insurance
- Dental insurance
Quick Apply
Account Resource Manager
AIS Healthcare —Phoenix, AZ
- Full-time
- Clinic experience
- Mid-level
- 3 years
- Disability insurance
- Health insurance
Quick Apply
Medical Assistant
Az Asthma & Allergy Institute —Mesa, AZ
- Full-time
- Vital signs
- HIPAA
- Mid-level
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
Procedure Scheduler
CVAM, CardioVascular Associates of Mesa, P.C. —Mesa, AZ
- From $18 an hour
- Full-time
- Mid-level
- Patient care
- US work authorization
- Disability insurance
- Health insurance
Quick Apply
21h
Registered Nurse (RN)
GARDAWORLD FEDERAL SERVICES LLC —Surprise, AZ
- $46.00 - $51.09 an hour
- Weekends as needed
- Background check
- CPR Certification
- Nursing
Quick Apply
High Needs Case Manager Children Services
Spectrum Healthcare —Phoenix, AZ
- From $22 an hour
- Full-time
- Background check
- Clean driving record
- Mid-level
- Health insurance
- Flexible schedule
Quick Apply
Authorization Coordinator
Phoenix Heart PLLC —Glendale, AZ
- Customer service
- Mid-level
- High school diploma or GED
Surgery Scheduling Coordinator
Ophthalmic Surgeons & Physicians Ltd. —Tempe, AZ
- $22.50 - $25.50 an hour
- Full-time
- High school diploma or GED
- US work authorization
- In-person
- Free parking
- Health savings account
Quick Apply
Prior Authorization Coordinator I
MedImpact Healthcare Systems —Tempe, AZ
- $17.69 - $27.41 an hour
- Overtime
- Microsoft Word
- Microsoft Outlook
- Computer literacy
- Paid holidays
- Disability insurance

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Prior Authorization Representative I

Arizona Priority Care -
Chandler, AZ

Apply Now

Job Details

Full-time
$20 - $23 an hour

Qualifications

Administrative experience
High school diploma or GED
ICD-10
HCPCS
Desktop applications
Medical terminology

Full Job Description

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers. We have operated in the Arizona market for more than 14 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost.

The Prior Authorization Representative I is responsible for processing incoming requests including verifying eligibility and benefits and the data entry component of the prior authorization request. The PA Rep I works closely with all UM Staff, Prior Auth Supervisor, and management to maintain turnaround time requirements of the contracted health plan, regulatory bodies, and internal goals. Routinely interacts with physicians, their office staff and internal customers.

POSITION DUTIES & RESPONSIBILITIES

Assist in managing the incoming prior authorization request by following work direction given by the Prior Authorization management to ensure Routine/Standard and Urgent/Expedited prior authorizations are processed in the appropriate amount of time and in compliance with regulatory and health plan requirements.
Complete a minimum data entry or adjudication of 40 authorizations per day.
Assist in reviewing and distributing incoming prior authorization requests including identifying Urgent/Expedited vs Routine/Standard, verifying member eligibility, delegated vs non-delegated services, retro vs. future date of services, accuracy checking documentation, and routing to appropriate folder.
Perform data entry of prior authorization requests with a minimum of 97% accuracy including primary insurance or hospice verification, determine if requested services require prior authorization, and confirm request is not duplicative.
Perform adjudication of authorization requests with a minimum of 97% accuracy including quality checking data entry, reviewing historical utilization management history to include program enrollment and verifying if rendering provider and facility is contracted, any tasks related to processing a prior authorization request (provider loads, out of network (OON) credentialing, accreditation verification, etc.), providing redirect information for OON requests, and routing to the appropriate queue or vendor.
Contact the provider’s office for additional information per CMS and AZPC policies and guidelines.
Make expedited determination notifications to member and provider.
Provide exceptional, courteous, and professional phone customer service.
Educate practitioners as needed with the Authorization/Referral process.
Perform as necessary accommodate to departmental change, workload and emergencies.
Maintain current knowledge of CMS and NCQA standards, and AZPC UM Policies and procedures.
Protect privacy for patients, providers, and employees; ensure all personal health information is kept confidential.
Demonstrate caring, empathy, patience, respect and compassion for all team members.
Demonstrate honesty and integrity in everyday activities.
Perform other duties as directed by management.

EDUCATION, TRAINING AND EXPERIENCE

Highschool Diploma or GED – Required.
Minimum of 1-year administrative healthcare related experience – Required.
Proficient knowledge of medical terminology, CPT-4, HCPCS, and ICD-10 – Required.
Working knowledge of computer applications, such as Microsoft Office applications.
Excellent oral and written communication skills.
Demonstrated ability to be detail-oriented and multi-task effectively.
Able to interact effectively with all levels of staff.

Pay Range: $20.00 – $23.00/hour

*This role requires 60 days FT in office presence, hybrid options will be available after the 60-day period.*

Apply Now

Refine Your Search

prior authorization jobs in phoenix az

Prior Authorization Representative I

Unit Support Associate

Representative - Admissions Services

Administrative Assistant

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

Case Manager - Phoenix, AZ

ER Registration Admitting

Prior Authorization Specialist

Medical Assistant

Medical Assistant

Medical Assistant (Gilbert)

Account Resource Manager

Medical Assistant

Therapy Care Specialist - Acute Infusion Pharmacy Technician

Procedure Scheduler

Registered Nurse (RN)

High Needs Case Manager Children Services

Authorization Coordinator

Surgery Scheduling Coordinator

Prior Authorization Coordinator I

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

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