Authorizations Coordinator
RemoteIndia or Colombia
Job Summary
Manage the end-to-end prior authorization and referral process for patient services, ensuring requests are accurately initiated, tracked, and completed per payer requirements and medical policies. Receive, review, and process authorization requests while verifying patient demographics, insurance eligibility, benefits, and referral requirements. Work within EMRs, payer portals, and authorization platforms such as Availity to obtain and enter authorizations prior to patient services. Communicate with provider offices, physicians, and insurance representatives to gather documentation and resolve issues, assisting patients with collecting supporting materials when appropriate. Maintain accurate logs of open cases, pending documents, and action items while monitoring authorization status to prevent delays in care or claim processing. Identify and escalate denials, missing documentation, or payer discrepancies, responding to emails, calls, and messages in a timely manner. Support benefit verification tasks and assist with customer service calls as needed, maintaining productivity targets for daily or weekly case submissions.
Required Qualifications
- 1–3+ years of experience in prior authorizations, medical billing, revenue cycle management, or a related healthcare administrative role
- Strong knowledge of insurance verification, benefits, referrals, payer requirements, and authorization workflows
- Experience using EMRs, payer portals, and authorization platforms such as Availity or similar tools
- Familiarity with CPT coding, ICD-10 diagnosis codes, and medical documentation review
- Understanding of payer policies, authorization requirements, denial scenarios, and follow-up processes
- Ability to accurately verify patient demographics, insurance eligibility, benefits, and required documentation
- Proficiency in Microsoft Office tools, including Excel, Outlook, and Teams
- Comfortable working with general workflow tools, web browsers, softphone systems, and healthcare technology platforms
- Ability to manage high-volume case loads while meeting submission targets and deadlines
- Strong written and verbal communication skills
- Excellent organizational skills and attention to detail
- Ability to assess problem areas, identify root causes, and resolve issues effectively
- Strong time management and prioritization skills, especially when handling urgent versus routine cases
- Ability to multi-task in a fast-paced environment
- Customer and client-focused approach with a commitment to responsiveness and service quality
- Ability to work full-time during regularly scheduled business hours, with additional hours as needed
- Ability to work from home with integrity, accountability, and professionalism
Desired Qualifications
- experience in prior authorizations, medical billing, or revenue cycle management
- strong attention to detail
- excellent communication skills
- the ability to manage a high-volume workload in a remote environment
- you like a fast-paced environment
- you thrive with change and development
- you like giving feedback
- you're a team player
- you love learning/sleuthing
- you're big on accountability
- Smart
- talented
- tech-savvy
- experienced
- go-getter types
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