Authorization Coordinator

About the Role:

The Authorization Coordinator plays a critical role in managing and facilitating the authorization process for healthcare services, ensuring timely and accurate approvals from insurance providers. This position serves as a liaison between healthcare providers, insurance companies, and patients to verify coverage and secure necessary authorizations for treatments and procedures. The successful candidate will be responsible for maintaining compliance with regulatory requirements and internal policies while optimizing workflow efficiency. By effectively coordinating authorizations, the Authorization Coordinator helps minimize delays in patient care and supports the financial integrity of the healthcare organization. This role requires strong organizational skills, attention to detail, and the ability to communicate clearly with diverse stakeholders.

Minimum Qualifications:

• High school diploma or equivalent; associate degree or higher preferred.
• Minimum of 2 years experience in healthcare administration, medical billing, or insurance authorization processes.
• Proficiency with electronic health record (EHR) systems and medical insurance portals.
• Strong knowledge of insurance terminology, medical coding, and healthcare regulations.
• Excellent communication and organizational skills.

Preferred Qualifications:

• Certification in medical billing, coding, or healthcare administration (e.g., CPC, CPB, or similar).
• Experience working with multiple insurance providers and familiarity with various insurance plans.
• Background in a clinical setting or direct experience supporting healthcare providers.
• Advanced proficiency in data management software and Microsoft Office Suite.
• Demonstrated ability to handle high-volume authorization requests efficiently.

Responsibilities:

• Review and process authorization requests for medical services, procedures, and treatments in accordance with insurance guidelines and organizational policies.
• Communicate with insurance companies to obtain pre-approvals and resolve any issues or denials related to authorizations.
• Collaborate with healthcare providers and administrative staff to gather necessary documentation and ensure completeness of authorization requests.
• Maintain accurate records of authorization status and follow up on pending or expired authorizations to prevent delays in patient care.
• Monitor changes in insurance policies and regulations to ensure ongoing compliance and update internal procedures accordingly.

A conditional job offer is contingent upon successfully passing a pre-employment drug test and background checks. A Physical Capacity Profile may be required for some positions.