Pre-Authorization Specialist II

Looking for a career where you love what you do and who you do it with? You’re in the right place.

Healthcare here is different – we’re locally owned and led by our physicians, and all decisions are always made right here in Central Iowa.

By working at The Iowa Clinic, you’ll get to make a difference while seeing a difference in our workplace. Because as one clinic dedicated to exceptional care, we’re committed to exceeding expectations, showing compassion and collaborating to provide the kind of care most of us got into this business to deliver in the first place.

Think you’ve got what it takes to join our TIC team? Keep reading…

Wondering what a day in the life of Pre-Authorization Specialist II at The Iowa Clinic might look like?

The Pre-Authorization Specialist II is responsible for managing complex and high-priority pre-authorization requests for procedures, exams, and medications. This role requires advanced knowledge of insurance requirements, CPT/ICD coding, and payer policies. Specialist II serves as a resource for team members, handles escalated cases, and ensures compliance with regulatory and payer guidelines while maintaining exceptional accuracy and timeliness.

• Handles appeals, peer-to-peer requests, and negotiates with payers on complex or high-dollar denials.
• Maintains advanced knowledge of CPT codes, ICD diagnosis codes, and payer-specific approval criteria.
• Audits charts for compliance and accuracy, identifies trends in missing documentation.
• Challenges insurance companies professionally when pre-authorizations are unjustly denied.
• Provides guidance and training to Pre-Authorization Specialist I staff.
• Maintains positive relationships with insurance company personnel and efficiently works through obtaining pre-authorizations through contact with them when necessary, including participating in the insurance-initiated nurse review process.
• Promotes a positive, professional image of The Iowa Clinic, both externally and internally.
• Maintains compliance with HIPAA and all regulatory requirements as well as confidentiality of financial information.

• High school diploma or equivalent required.

• Minimum 2-3 years of experience in pre-authorization, medical billing, or related healthcare field.

• Certification in medical billing/coding (e.g., CPC) preferred.

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• One of the best 401(k) programs in central Iowa, including employer match and profit sharing
• Employee incentives to share in the Clinic’s success
• Generous PTO accruals
• and paid holidays
• Health, dental and vision insurance
• Quarterly volunteer opportunities through a variety of local nonprofits
• Training and development programs
• Opportunities to have fun with your colleagues, including TIC night at the Iowa Cubs, employee appreciation tailgate party, Adventure land day, State Fair tickets, annual holiday party, drive-in movie night… we could go on and on
• Monthly departmental celebrations, jeans days and clinic-wide competitions
• Employee rewards and recognition program
• Health and wellness program with up to $350/year in incentives
• Employee feedback surveys
• All employee meetings, team huddles and transparent communication