Prior Authorization Specialist - MA/LPN

Advanced Pediatric Associates is seeking an experienced Prior Authorization Specialist to join our administrative team. This full-time, on-site position plays a vital role in ensuring the timely and accurate processing of prior authorizations, helping our pediatric patients access the medications, procedures, and services they need without delay.

This role is ideal for a Prior Authorization Specialist with 2–3 years of hands-on experience—particularly in a pediatric setting—or a Medical Assistant (MA) or Licensed Practical Nurse (LPN) with strong administrative skills and a background in prior authorization workflows. 

Schedule: 5 days per week, day shift, Monday - Friday

Please note: This position requires in-office work at our administrative office in Aurora (I-225 & Parker Rd) and is not eligible for remote work.

Salary Range: $21 - $26 per hour, based on experience and qualifications.

Benefits:

• Consistent daytime schedule – no evenings or weekends
• Paid Time Off (PTO) and Extended Illness Bank (EIB) – accruing from day one
• 401(k) plan (eligibility based on classification)
• Medical, dental, and vision insurance (eligibility based on classification)
• Life, AD&D, and Long-Term Disability (LTD) insurance
• Additional benefits: accident insurance, Employee Assistance Program (EAP) (eligibility based on classification)
• Supportive work culture centered on pediatric healthcare

Key Responsibilities:

• Review and process prior authorization requests for medications, procedures, and services
• Collaborate with providers, pharmacies, and insurance companies to ensure accurate and timely approvals
• Manage and respond to message threads and inquiries related to prior authorizations
• Maintain detailed, accurate records in the Electronic Medical Record (EMR) system
• Communicate effectively with patients, families, and providers regarding coverage status and next steps
• Schedule appointments and provide administrative support as needed
• Ensure compliance with internal guidelines and insurance payer policies

• 2–3 years of recent experience in prior authorization processing, preferably in a pediatric or family medicine setting
• OR Medical Assistant (MA) with 5+ years in a clinical or administrative healthcare environment
• OR Licensed Practical Nurse (LPN); minimum of six months professional LPN experience, preferably in pediatrics and  prior authorization experience preferred
• Proficient in EMR systems and prior authorization workflows
• BLS certification is required
• Strong organizational, multitasking, and communication skills
• Knowledge of insurance plans, medical terminology, and healthcare procedures
• Ability to remain calm and efficient in a fast-paced, team-oriented environment

If you're an experienced healthcare professional passionate about pediatric care and skilled in navigating prior authorization processes, we’d love to hear from you.

Advanced Pediatrics is an equal opportunity employer and prohibits discrimination and harassment of any type with regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.