Medical Prior Authorization Coordinator

Responsibilities

• Verifying insurance coverage and eligibility
• Submitting and tracking authorization requests
• Interpreting medical necessity guidelines
• Collaborating with providers, nurses, and payers to ensure timely approvals
• Documenting all authorization activities accurately
• Communicating approval decisions to patients and clinical staff
• Assisting in resolving claim denials and delays

Qualifications and Skills

• Attention to detail and strong organizational skills
• Knowledge of insurance policies and medical necessity criteria
• Effective communication and collaboration abilities
• Ability to work in a healthcare setting supporting patient-centered care