Prior Authorization Specialist

Arizona Eye Specialists is a busy, valley-wide Ophthalmology practice, proudly serving our Patients since 1953! We are seeking a Prior Authorization Specialist to support a multi-site/multi-provider Ophthalmology practice.

The Authorization Specialist is responsible for securing and managing prior authorizations for ophthalmology procedures. This role ensures accurate insurance verification, timely approval, and seamless coordination between patients, providers, and payors. The ideal candidate is organized, communicative, and experienced with ophthalmology related authorization requirements.

* This is a full-time, in-office position, 40 hours per week, located at our corporate office. The starting pay is between $20–$23 per hour.

Key Responsibilities:

• Verify eligibility and benefits for scheduled patients prior to patient appointments and same day appointments.
• Interface with credentialing, scheduling, authorization & referrals team on additional information needed prior to check-in.
• Interface with payers and patients to obtain missing/invalid information.
• Ensure network participation status of providers.
• Take proper action on out of network participation status of providers.
• Communicate additional information needed from patient with the front office staff prior to patient appointment.
• Note patients’ accounts accurately and in detailed manner.
• Research and correct any claim rejections from the clearinghouse for insurance eligibility and demographics errors.
• Create and Maintain eligibility spreadsheets to manage and track eligibility files.
• Attend meetings and educational training as needed.
• Assist with month end close.
• Perform other duties that support the organization as requested.

Required Experience

• High school diploma or equivalent
• 2–3 years of experience in medical authorization, billing, or insurance verification
• Familiarity with major insurance providers and prior authorization processes
• Strong communication and problem-solving skills

Preferred:

• Experience in ophthalmology or specialty medical practice
• Knowledge of ophthalmology procedures and medical terminology
• Proficiency with EHR systems (e.g., ModMed)
• Certification in medical billing/coding (CPC, CCA, or similar)

Job Type: Full-time

Pay: $20.00 - $23.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Employee discount
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Retirement plan

Education:

• High school or equivalent (Required)

Experience:

• Ophthalmology: 1 year (Preferred)
• Insurance Eligibility: 2 years (Preferred)

Language:

• Spanish (Preferred)

Ability to Commute:

• Phoenix, AZ 85016 (Required)

Work Location: In person

Salary : $20 - $23