Prior Authorization Coordinator – Responsibilities and Qualifications

Key Responsibilities:

Review patient insurance policies to determine specific prior authorization requirements based on CPT codes for all upcoming surgical procedures.

Initiate prior authorization requests through provider portals, phone communication, or fax submission.

Track and follow up on submitted authorization requests, ensuring approvals are obtained and properly attached and linked to the patient’s scheduled appointment.

Prepare and submit appeals when authorization requests are denied or require reconsideration.

Communicate with patients when necessary to explain the prior authorization process or request additional required information.

Accurately document all prior authorization activities in patient charts to ensure the care team is informed prior to the patient’s appointment.

Monitor Microsoft Teams chats for questions, clarifications, or appointment updates that may impact prior authorization status in real time.

Qualifications:

Strong attention to detail and organizational skills.

Effective verbal and written communication skills.

Proficiency with Microsoft Teams, Outlook, and Excel preferred.

Strong problem analysis and resolution skills.

Ability to effectively multitask while working across multiple computer-based information systems.

Capacity to work independently and remain productive in a self-directed environment.

Requirements

This is a full time role

Up to $6/hr

Important Notice:

By submitting your application, you acknowledge and provide your explicit consent to the collection, processing, storage, and use of the personal information contained in your application. You agree that Remote Raven may contact you using the details provided for recruitment and talent management purposes.

You further authorize Remote Raven to retain your information within its database for consideration in current and future employment opportunities, in compliance with applicable data protection and privacy regulations.

Originally posted on Himalayas

Prior Authorization Coordinator