Prior Authorization/Medical Assistant

We are seeking a detail-oriented Prior Authorization Specialist with Clinical Medical Assistant floor experience to join our team and take ownership of the full authorization process - from eligibility verification through approval - ensuring our patients receive timely access to care.

This role supports a high-volume outpatient pain management specialty practice and requires strong organizational skills and the ability to manage multiple payer requirements simultaneously.

What we offer:
• Stable, growing specialty practice
• Team-oriented environment
• Competitive pay
• Medical Benefits
• Long Term/Short Term Disability
• 401K

Key Responsibilities:
• Prioritizes incoming prior authorization requests
• Review and complete tasks being received from clinical departments, review authorization log to verify all request are being met.
• Comfortable reviewing and interpreting Provider EHR orders
• Provides needed documentation to insurance companies in accordance with mandated insurance regulations via fax, online, or telephone to obtain procedure authorizations.
• When needed, sets up "Peer to Peer" for physicians to provide requested information to the insurance plan.
• Verifying insurance benefits for commercial and governmental payers
• Efficiently obtain all authorizations for procedures prior to the day of service
• Calling all patients to ensure appointment times are confirmed prior to appointment, while confirming the patient is in good health and following practice policy to perform any procedure
• Must be comfortable communicating with providers and office staff when clinical information is required to coordinate insurance authorizations
• Assist with incoming phone lines, scheduling of established and new patients
• Scheduling patients for procedures after insurance prior approval is obtained
• Ability to switch to working the clinical floor as necessary
• Assist with wheeling patients to and from procedures

Qualifications:
• All applicants to be considered, MUST have 3-5 years of recent experience handling procedural prior authorizations in a medical office setting with clinical Medical Assistant experience.
• Strong knowledge of commercial and government payer guidelines.
• Experience navigating payer web portals and submitting clinical documentation.
• Excellent communication and follow-up skills

Pima Pain Center is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, national origin, sex (including gender identity, and gender expression), sexual orientation, pregnancy (including childbirth, lactation, and related medical conditions), disability, current or prior uniformed service, marital status, or any other legally protected class.

Job Type: Full-time

Benefits:
• 401(k)
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Retirement plan
• Vision insurance

Work Location: In person