Prior Authorization Coordinator

Job Summary

Supporting the Medical Management team, the full-time Prior Authorization Coordinator will investigate and process prior authorization requests while working from home.

Key responsibilities:

• Review and research referral and authorization requests, processing them according to guidelines
• Provide education to members and providers regarding the prior authorization process
• Ensure timely processing of documentation and maintain compliance with HIPAA and other regulatory guidelines

Required qualifications:

• High school education or equivalent
• 1-2 years of experience in a medical office and/or insurance environment
• Strong understanding of medical terminology, coding, and health plan benefits
• Proficiency in Microsoft Office applications and typing skills (minimum 35 wpm)
• Ability to analyze claims and authorizations for accuracy and compliance