Prior Authorization and Referral Specialist

Prior Authorization and Referral Specialist

Join to apply for the Prior Authorization and Referral Specialist role at Family Eye Physicians
. This is a full‑time, onsite position in Oak Brook Terrace, IL. In this role you will request and complete authorizations and referrals for our ophthalmology practice, ensuring we have the prior authorization and/or referral needed to move forward with patients’ appointments or procedures.

• Review appointment schedules and process prior authorization requests for medical services
• Verify patient insurance coverage and eligibility for requested services
• Monitor schedules for potential issues prior to appointment date
• Interact with insurance companies to submit authorization requests and follow up on pending approvals
• Contact referring physicians for additional information as needed
• Maintain accurate records of authorization requests and outcomes in the electronic health record (EHR) system
• Assist patients, internal staff, and physicians in understanding authorization requirements and processes
• Collaborate with the billing team to resolve authorization‑related issues and ensure continuity of care
• Provide training and support to new staff on prior authorization procedures
• Prepare reports and analyze data related to authorization trends and outcomes

• High school diploma or equivalent; associate’s degree in a relevant field preferred
• Previous experience (1‑2 years) in a prior authorization or medical billing role is highly desirable
• Strong knowledge of medical terminology, coding, and insurance regulations
• Excellent communication and interpersonal skills
• Detail‑oriented with strong organizational and time‑management abilities
• Proficient in using EHR systems and Microsoft Office Suite; knowledge of Nextech / Practice Plus preferred
• Proficient in utilizing insurance portals including Availity, UHC, Humana, Cigna
• Ability to work independently and as part of a team in a fast‑paced environment

Entry level

Full‑time

Health Care Provider

Wellness and Fitness Services