Prior Authorization Specialist

Prior Authorization Specialist Full-Time | On-Site – Mesa, AZ Western Vascular Institute is seeking a Full-Time Prior Authorization Specialist to join our busy and growing Vascular Clinic! We’re looking for a hardworking, detail-oriented, and positive individual who thrives in a fast-paced medical environment. The ideal candidate will be a team player who enjoys collaborating with physicians, staff, insurance companies, and patients to ensure timely insurance authorizations and exceptional patient care.

Position Overview

As a Prior Authorization Specialist, you’ll be responsible for obtaining, managing, and tracking insurance authorizations for surgical procedures, in-office treatments, diagnostic imaging, and other specialty services. You’ll work closely with physicians, clinical staff, surgery schedulers, and insurance providers to ensure all necessary approvals are obtained accurately and efficiently, minimizing delays in patient care.

Essential Duties

& Responsibilities Obtain, submit, and track prior authorizations for in-office and hospital-based surgical procedures, diagnostic imaging, and other medical services. Verify patient insurance eligibility, benefits, coverage requirements, and authorization guidelines. Prepare, submit, and maintain all necessary clinical documentation to meet insurance payer requirements.

Monitor pending authorizations and follow up with insurance companies to ensure timely approvals. Coordinate peer-to-peer reviews, reconsiderations, and appeals for denied or delayed authorization requests. Communicate effectively with physicians, clinical staff, surgery schedulers, and patients regarding authorization statuses and requirements.

Identify and resolve authorization barriers, including missing documentation, coverage limitations, and payer-related issues. Maintain accurate and up-to-date authorization records within the electronic medical record (EMR) system and insurance payer portals. Stay informed of changing insurance policies, authorization requirements, and payer guidelines.

Prioritize authorization requests based on scheduled procedure dates and patient needs. Maintain excellent relationships with physicians, staff, insurance representatives, and management.

Qualifications

& Skills 2+ years of prior authorization experience in a medical practice, surgery center, or hospital preferred. Strong understanding of medical terminology, insurance verification, and prior authorization processes. Knowledge of Medicare, Medicare Advantage, and commercial insurance plans. Experience with surgical authorizations, specialty procedures, or vascular services preferred.

Proficient in computers, EMR systems, and insurance payer portals; Next. Gen experience preferred. Excellent communication and interpersonal skills. Strong organizational and multitasking abilities with keen attention to detail. Ability to problem-solve, prioritize deadlines, and work independently or as part of a team.

Discretion and professionalism when handling confidential patient information. Positive attitude, flexibility, and a strong desire to learn. Bilingual (English/Spanish) preferred. We value candidates who demonstrate a strong work ethic, positive attitude, and eagerness to learn. While prior authorization experience is preferred, we are willing to provide additional training to the right candidate.

Benefits

401(k) with matching Health, dental, vision, and life insurance Disability insurance Paid time off & paid sick time Supportive and collaborative team environment Why Join Western Vascular Institute? We’re looking for a long-term team member who wants to grow with us and contribute to our mission of providing exceptional vascular care.

As a Prior Authorization Specialist, you’ll play an important role in helping patients receive timely access to necessary procedures and treatments while supporting our physicians and clinical team. If you’re motivated, reliable, and ready to make a difference — we’d love to meet you!