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Prior Authorization Utilization Review Jobs in Kansas

Sabates Eye Centers

Surgery Scheduler

Leawood, KS · On-site

$18.25 - $23.50/hr

Confirms patients' insurance provider and either obtains prior authorization or communicates need ... Reviews discharge instructions with patients and ensures proper follow-up appointments are ...

Soliant Health

Staff Pharmacist | Eudora, Kansas

Eudora, KS · On-site

$54.50 - $64/hr

Conduct prospective drug utilization review (PV1) to ensure safe and effective medication use ... Prior experience in Long-Term Care (LTC) pharmacy is highly preferred. * Retail MTM pharmacist ...

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Prior Authorization Utilization Review information

What is a Prior Authorization Utilization Review specialist?

A Prior Authorization Utilization Review specialist is a healthcare professional responsible for evaluating medical service requests to ensure they meet specific criteria for approval before services are provided. Their main role is to review clinical information, verify medical necessity, and ensure compliance with insurance policies and guidelines. They act as a liaison between healthcare providers, insurance companies, and patients to facilitate timely and accurate authorization decisions. This process helps to manage healthcare costs and ensure patients receive appropriate care.

What are the key skills and qualifications needed to thrive as a Prior Authorization Utilization Review specialist?

To thrive as a Prior Authorization Utilization Review Specialist, you need a strong understanding of medical terminology, insurance guidelines, and clinical criteria, often supported by a degree in healthcare or nursing and relevant certification (such as RN or LPN). Familiarity with prior authorization software, electronic health record (EHR) systems, and payer portals is typically required. Attention to detail, strong communication skills, and the ability to multitask help professionals excel in this role. These competencies ensure accurate and timely processing of authorizations, reducing delays in patient care and ensuring compliance with payer requirements.

What are some common challenges faced by professionals in Prior Authorization Utilization Review roles, and how can these be managed?

Professionals in Prior Authorization Utilization Review often encounter challenges such as navigating complex insurance policies, managing high volumes of requests, and ensuring timely communication between providers and payers. Staying organized, developing a thorough understanding of payer guidelines, and maintaining clear, consistent communication are key strategies for managing these challenges. Many teams also rely on workflow management tools and regular team huddles to streamline processes and ensure all cases are handled efficiently.

What is the difference between Prior Authorization Utilization Review vs Medical Reviewer?

AspectPrior Authorization Utilization ReviewMedical Reviewer
CredentialsLicensed healthcare professionals, often with certifications in utilization reviewLicensed physicians or healthcare providers with clinical expertise
Work EnvironmentInsurance companies, healthcare organizations, or third-party review firmsHospitals, clinics, insurance companies, or consulting firms
Primary FocusAssessing the necessity of procedures or treatments before approvalEvaluating clinical records to determine medical necessity and appropriateness

While both roles involve clinical assessment, Prior Authorization Utilization Review focuses on pre-authorization decisions for treatments, whereas Medical Review involves detailed clinical evaluation of patient records to determine medical necessity. Both require healthcare credentials and are integral to healthcare quality and cost management.

What are popular job titles related to Prior Authorization Utilization Review jobs in Kansas?

For Prior Authorization Utilization Review jobs in Kansas, the most frequently searched job titles are:

What job categories do people searching Prior Authorization Utilization Review jobs in Kansas look for?

The top searched job categories for Prior Authorization Utilization Review jobs in Kansas are:

Prior Authorization Utilization Review jobs near you
Infographic showing various Prior Authorization Utilization Review job openings in Kansas as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Surgery Scheduler

Eye Care Partners Career Opportunities

Leawood, KS • On-site

$18.25 - $23.50/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

Job description

Job Title: Surgery Scheduler
Company: Sabates Eye Centers
Location: Leawood, KS 66211

**RECENT SURGERY SCHEDULING EXPERIENCE IS REQUIRED**

Perks:

  • Full Benefits Package - Medical, Vision, Dental and Life Insurance
  • 401k + Employer Matching
  • Paid Time Off (PTO) and Paid Holidays
  • Paid Maternity Leave
  • Employee Discounts
  • Competitive Base Pay

Hours:

  • Full Time
  • Our offices are open Monday-Friday 8:00am-5:00pm, plus rotating Saturdays from 8am-12pm
    • You must have open availability to work any/all shifts within these hours.
    • You may need to work a little earlier and/or later as needed.

Requirements:

  • High School Diploma or GED Equivalent
  • Favorable result on Background Check
  • Experience working in the medical field is required
  • Bilingual in English and Spanish is preferred, but not required
  • Basic computer skills
  • Strong customer service skills
  • Excitement to learn and grow

SUMMARY

The Surgery Scheduler schedules office-based and hospital procedures consistent with the patient's diagnosis and procedure request.

ESSENTIAL DUTIES AND RESPONSIBILITIES 

  • Schedules office- and hospital-based medical procedures for patients with appropriate provider and time/location slot, utilizing appropriate scheduling code.
  • Schedules diagnostic and imaging tests to be completed at PMG.
  • Schedules office- and hospital-based medical procedures, tests and imaging ensuring available time is utilized to maximum efficiency.
  • Interfaces with appropriate vendor staff to ensure all necessary equipment will be on site for office- and hospital-based procedures, including scheduling with contracted anesthesia groups.
  • Interfaces with appropriate hospital staff to ensure a cohesive working relationship in providing patient care serves.
  • Enters notes/special instructions needed for scheduling in the Electronic Medical Record (EMR).
  • Effectively utilizes clinical knowledge when determining if appointment is consistent with the diagnosis/indications indicated by the provider.
  • Completes accurate documentation of informed consent with patients for procedures and surgeries as needed.
  • Provides accurate, detailed information to patients regarding test preparations, time of patients' scheduled arrival, and any other directional information needed; takes appropriate action in responding to questions from patients.
  • Confirms patients' insurance provider and either obtains prior authorization or communicates need for prior authorization to appropriate parties as needed.
  • Ensures patients have proper medical clearance and pre-surgical testing as needed.
  • Completes pre-procedure phone calls and confirms appointment times with patients via telephone.
  • Ensures completion of assessment for advance directive, including DNR when applicable.
  • Reviews discharge instructions with patients and ensures proper follow-up appointments are scheduled at the time the procedure is scheduled.
  • Performs all aspects of patient care in an environment that organizes patient safety and reduces the likelihood of medical/health care errors.
  • Assists other members of the department as needed.
  • Other duties as assigned.

QUALIFICATIONS:

  • This position requires utilization of clinical knowledge to schedule appropriate procedures/surgeries per provider's orders.
  • Excellent customer service skills with patients, employees, and the public is required.
  • Must be able to respond to both written and oral correspondence regarding scheduling changes/cancellations in a timely, accurate manner.
  • Individual must be organized, and be able to manage demanding workload with accuracy.

EDUCATION AND/OR EXPERIENCE 

  • High School Diploma or GED equivalent required
  • Experience in surgery scheduling is required
     

LICENSES AND CREDENTIALS 

  • Minimum Required: None
     

SYSTEMS AND TECHNOLOGY  

  • Proficient in Microsoft Excel, Word, PowerPoint, Outlook
     

PHYSICAL REQUIREMENTS

  • This role requires a variety of physical activities to effectively perform essential job functions. The position involves frequent walking (75%), sitting (50%), and standing (50%), with regular bending, stooping, and reaching (25-50%). Employees must be able to lift, carry, push, and pull items up to 25 lbs. Strong fine motor skills and full use of hands are essential, as the role demands constant grasping, writing/typing, and use of technology. Visual and auditory acuity-including color, depth, peripheral vision, and the ability to adjust focus-is required 100% of the time. Occasional driving or climbing may also be necessary. 

If you need assistance with this application, please contact (636) 227-2600. Please do not contact the office directly - only resumes submitted through this website will be considered.

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

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