Insurance and Prior Authorization Manager
About the job
- A high school diploma or equivalent is required.
- Three years of medical authorization experience are required.
- Two or more years in a leadership role are required.
- Maintain active knowledge of Centers for Medicare & Medicaid Services guidelines, contracted insurance guidelines, and coding policies.
- Demonstrate the ability to lead a team with a positive attitude, openness to change, willingness to help, and respect for others and their ideas.
- Demonstrate verbal and written communication skills.
- Be detail-oriented and reliable, and able to multitask in a fast-paced, high-volume work environment.
- Demonstrate computer literacy and math skills.
- Maintain a high level of confidentiality and professionalism.
- Monitor and manage assigned employees’ productivity and performance, including daily, weekly, and monthly department metrics; report to senior leadership and provide action plans for improvement.
- Provide leadership and frequent performance feedback to team members, and invite two-way communication.
- Coach established employees when needs are identified and hold employees accountable for results through coaching and development of action plans.
- Monitor prior authorization and eligibility automation processes.
- Assist the IT team in developing automation processes for authorization submission and tracking, and insurance verification.
- Work closely with the billing team on claim denials related to authorization and eligibility.
- Produce productivity and error reports to assess staff.
- Prioritize work to maximize turnaround time.
- Contact insurance plans to determine eligibility and obtain coverage and benefit information.
- Contact insurance plans to obtain prior authorization for services.
- Document findings thoroughly and accurately.
- Train organizational staff on procedures for requesting, documenting, and processing prior authorizations.
- A bachelor’s degree specializing in health information administration is preferred.
- A strong background and experience in revenue cycle management are preferred.
About the company
USA Clinics Group runs a nationwide network of over 160 outpatient clinics, with centers such as USA Vein Clinics, USA Fibroid Centers, USA Vascular Centers, USA Pain Center, USA Prostate Centers, USA Oncology Centers, USA Hemorrhoid Centers, and USA Longevity Centers. Its team of interventional radiologists and vascular surgeons provide minimally invasive treatments for conditions like varicose veins, uterine fibroids, peripheral artery disease, hemorrhoids, benign prostate hyperplasia, knee osteoarthritis, and liver cancer. Treatments are delivered in outpatient settings with coordinated care paths across the network, focusing on safe, effective, and symptom-relieving options. The goal is to be a trusted, compassionate partner on each patient’s treatment journey and to improve quality of life through accessible, coordinated care across a wide range of conditions.
Company Size
201-500
Company Stage
N/A
Total Funding
N/A
Headquarters
Northbrook, Illinois
Founded
2005
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Simplify's Take
What believers are saying
- AP News coverage on January 18, 2026 boosted national awareness of USA Clinics Group.
- The company reported over 170 clinics on ZipRecruiter listings in August 2026.
- July 22-23, 2026 hiring events for 38 coordinators show continued operating expansion.
What critics are saying
- Medical Management of Chicago settled a TCPA text case for $574,350 on August 7, 2026.
- The June 12, 2025 Simpkins TCPA lawsuit signals expensive marketing-compliance exposure.
- False Claims Act litigation in Hennessy v. USA Vein Clinics of Texas threatens reimbursement credibility.
What makes USA Clinics Group unique
- USA Clinics Group reached 168 accredited locations by January 18, 2026.
- It combines vein, fibroid, vascular, prostate, hemorrhoid, and knee arthritis outpatient care.
- Northbrook-based scale and flexible outpatient model create dense referral and branding advantages.
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Benefits
- Health Insurance
- Dental Insurance
- Vision Insurance
- Health Savings Account/Flexible Spending Account
- Paid Time Off
- 401(k) Retirement Plan