Authorization and Denials Coordinator

About the Role

Create the future of e-health together with us by becoming an Authorization and Denials Coordinator. At CompuGroup Medical, we have the mission of building ground-breaking solutions for digital healthcare. Our vision is revolutionizing how healthcare professionals produce, access, and utilize information, enabling them to focus on patient outcomes. We are seeking a dedicated candidate with excellent interpersonal skills for a role involving daily on-site relationship management with physicians, clinical staff, and practice administrators. The position offers a consistent Monday through Friday schedule, with no evening or weekend hours required.

Responsibilities

• Own the full authorization cycle: verify insurance eligibility and benefits, gather clinical documentation, submit prior authorization requests, and track pending approvals daily to prevent scheduling delays.
• Manage denials and appeals: analyze root causes of denied claims, draft documentation-backed appeal letters, track deadlines, and recover outstanding revenue by overturning invalid denials.
• Drive process improvement: identify recurring denial trends by payer or department, report findings to management, and educate front-end staff to prevent authorization errors.

Qualifications

• Experience: Minimum of 3 years in healthcare authorizations/revenue cycle, cardiology, internal medicine, multi-specialty practice billing, authorizations, appeals, denial management, and payer escalation processes.
• Knowledge: Strong working knowledge of insurance verification, referral management, and payer-specific authorization requirements.
• EHR/Billing Systems: Proficiency with medical software (e.g., Epic, Cerner, eClinicalWorks), clearinghouses, and NextGen or comparable EHR/practice management systems.
• Medical Terminology: Strong understanding of CPT, ICD-10, and HCPCS coding concepts.
• Payer Portals: Experience navigating major insurance portals (e.g., Availity, UnitedHealthcare, Medicare/Medicaid portals).

Benefits

• Medical, Dental, and Vision insurance.
• 401k with employer matching.
• Personal Time Off to promote work-life balance.
• Modern workplaces, flexible working hours, hybrid work options, and more.

Schedule

Monday–Friday schedule with no night or weekend shifts, promoting work-life balance.

Equal Opportunity Employer: At CGM, we value our team members and strive to create an environment where everyone has the opportunity to succeed. We offer a variety of internal career opportunities and numerous long-term perspectives in a secure, crisis-proof market.