Prior Authorization Coordinator

Job Summary

Providing essential support to the Medical Management team, the full-time Prior Authorization Coordinator will investigate and process prior authorization requests while working remotely.

Key responsibilities:

• Review and research referral and authorization requests, determining requirements based on plan type and codes
• Educate members and providers on the prior authorization process and gather necessary information for processing requests
• Ensure compliance with regulatory guidelines and maintain accurate documentation in the Moda Health systems

Required qualifications:

• High school diploma or equivalent
• 1-2 years of experience in a medical office or insurance environment
• Strong understanding of medical terminology, coding, and health plan benefits
• Proficiency in Microsoft Office applications and ability to type a minimum of 35 wpm
• Ability to analyze complex benefit packages and maintain confidentiality