To Apply for this Job Click Here
Job Title: Prior Authorization & Eligibility Clerk (Full-Time)
Location: Tucson, Arizona
Employment Type: Full-Time
Position Summary:
We are seeking a highly organized and detail-oriented Prior Authorization & Eligibility Clerk to join our healthcare team in Tucson, Arizona. This role is responsible for verifying patient insurance coverage, obtaining prior authorizations for medical services, and ensuring all requirements are met prior to treatment. The ideal candidate will play a key role in minimizing claim denials and ensuring a smooth patient financial experience.
Key Responsibilities:
- Verify patient insurance eligibility, benefits, and coverage prior to scheduled services
- Obtain and manage prior authorizations for procedures, diagnostic services, and medications as required by payers
- Communicate with insurance companies, providers, and patients regarding authorization requirements and status updates
- Accurately document authorization numbers, coverage details, and eligibility information in the system
- Identify and resolve issues that may delay authorization or impact reimbursement
- Maintain knowledge of payer guidelines, policies, and authorization requirements
- Collaborate with clinical, scheduling, and billing teams to ensure timely and accurate workflow
- Assist with appeals and retro-authorizations when necessary
Qualifications:
- High school diploma or equivalent required; additional coursework in healthcare administration preferred
- Minimum of 1–2 years of experience in prior authorizations, insurance verification, or medical office operations preferred
- Strong understanding of insurance plans, including Medicare, Medicaid, and commercial payers
- Familiarity with medical terminology, procedures, and basic coding (ICD-10, CPT, HCPCS)
- Experience with electronic health record (EHR) and practice management systems
- Excellent attention to detail and organizational skills
- Strong communication and customer service abilities
- Ability to multitask and work in a fast-paced healthcare environment
Work Environment & Schedule:
- Full-time position (40 hours per week)
- On-site or hybrid work options may be available depending on organizational needs
- Monday through Friday, standard business hours
Benefits (may vary by employer):
- Competitive salary
- Health, dental, and vision insurance
- Paid time off and holidays
- Retirement plan options
- Opportunities for training and career growth