Medical Authorization Specialist

Metro Vein Centers•West Bloomfield, MI

23h•Remote

About The Position

Metro Vein Centers is seeking a detail-oriented Medical Authorization Specialist to support our surgical authorization and front-end revenue cycle operations. This role is responsible for obtaining prior authorizations for medically necessary surgical procedures, reviewing clinical documentation for payer compliance, and helping ensure patients can move forward with care without unnecessary delays or denials. The ideal candidate has prior experience working with insurance portals, surgical authorizations, medical necessity documentation, and payer guidelines in a fast-paced healthcare environment. This is not an entry-level administrative role — success in this position requires strong critical thinking, urgency, attention to detail, and a solid understanding of insurance authorization workflows. This is a fully remote role supporting Metro Vein Centers’ growing national operations. The ideal candidate is highly organized, detail-oriented, and comfortable working independently in a fast-paced, high-volume authorization environment.

Requirements

Ability to work independently and maintain productivity in a fully remote environment
Strong understanding of medical prior authorizations, insurance verification, and payer guidelines
Experience working with surgical authorizations and medical necessity documentation
Comfortable navigating payer portals such as Availity and EMR systems
Strong organizational skills and ability to manage multiple cases and deadlines simultaneously
Excellent communication and collaboration skills when working with payers, providers, and operational teams
High attention to detail and documentation accuracy
Ability to work independently while contributing to a team-oriented revenue cycle environment
High school diploma or equivalent required
1–2+ years of prior authorization experience in a medical, surgical, outpatient, specialty practice, or healthcare revenue cycle environment required
Experience with insurance portals, authorization workflows, and payer follow-up required

Nice To Haves

Centricity / Athena experience preferred
Prior experience with vascular, surgical, radiology, orthopedic, pain management, cardiology, or specialty procedure authorizations strongly preferred

Responsibilities

Submitting prior authorizations for medically necessary procedures
Reviewing patient charts and clinical documentation for payer requirements
Working within insurance portals such as Availity throughout the day
Following up on authorization requests, denials, and additional documentation needs
Communicating with payers, providers, and clinical teams to resolve authorization issues
Updating authorization status and detailed notes within the EMR system
Managing multiple cases simultaneously while maintaining accuracy and turnaround times
Submit and manage prior authorization requests for surgical and procedural services
Review patient charts and supporting documentation to ensure medical necessity requirements are met
Work directly within payer portals including Availity to process and track authorization requests
Follow up on pending authorizations, denials, and requests for additional clinical information
Communicate with insurance companies, providers, and internal departments to resolve authorization-related issues
Maintain accurate authorization documentation and case notes within the EMR system
Monitor payer guidelines and authorization requirements to help reduce denials and delays in patient care
Support a high-volume work environment while maintaining strong attention to detail and productivity standards