Prior Authorization Specialist

JOB TITLE: PRIOR AUTHORIZATION SPECIALIST

REPORTS TO: Revenue Cycle Manager

DEPARTMENT/LOCATION: Clinical, On-Site

JOB CLASSIFICATION: Permanent, Full-Time, Non-Exempt.

REQUIREMENTS: None

LAST MODIFIED: 6/23/2026

POSITION SUMMARY

As a Prior-Authorization Specialist, you will play a critical role in facilitating timely and efficient patient care by managing insurance prior-authorization processes. You will collaborate with providers, insurance companies, and support staff to obtain required approvals for diagnostic tests, treatments, and procedures—all in alignment with UCI’s mission and values.

ESSENTIAL FUNCTIONS

• Review provider orders and determine prior-authorization requirements for urologic diagnostics and treatments.
• Submit prior-authorization requests to insurance payers accurately and promptly.
• Track authorization statuses, follow up proactively, and resolve any issues (e.g., denials, appeals).
• Liaise with providers and patients to gather additional clinical documentation as needed.
• Maintain organized, compliant records of all authorization activities within the practice’s systems.
• Identify opportunities to optimize the authorization workflow.
• Serve as a resource for clinical and administrative team members regarding insurance protocols.

QUALIFICATIONS & REQUIREMENTS

• Experience in medical billing, insurance coordination, or prior-authorization—ideally within a urology or surgical specialty setting.

• Knowledge of insurance authorization procedures and coding fundamentals.

• Strong attention to detail, excellent organizational and communication skills.

• Ability to manage multiple tasks effectively while ensuring accuracy and follow-through.

• Commitment to compassionate, patient-centered support—aligned with UCI’s mission.

• Contribute to a collaborative, mission-driven environment focused on patient experience and seamless healthcare delivery.

• Make a meaningful impact on patient care and access to treatment.

WORKING ENVIRONMENT

This role is based in a fast-paced, patient-focused urology clinic where collaboration is key. Our team of physicians, nurses, and support staff work together in a modern facility equipped with an EHR system and on-site diagnostic services. The atmosphere is professional yet warm, with a shared commitment to delivering compassionate, high-quality care to a diverse patient population. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Potential exposure to infectious diseases, bloodborne pathogens and chemical cleaning agents. Electronic medical records (EMR) systems, phone systems and standard medical equipment.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Specific vision abilities required by this job include Close vision and Distance vision. While performing the duties of this job, the employee is required to sit for extended periods of time, and frequently stand and walk with bending and lifting up to 20-30 lbs.

COMPANY OVERVIEW

OUR MISSION: To provide compassionate, world-class urologic care and exceptional experiences for our patients, employees and partners.

OUR VISION: Curing the world of urologic disorders, one person at a time.

OUR VALUES**:At UCI, we are passionate about patient experienceand making the healthcare journey from diagnosis through treatment as easy and stress-free as possible! Throughunmatched integration and access**for patients, partner hospitals and other physicians in the community, we provide world-class urologic care in an attentive environment where you are at the center of all we do.