Prior Authorization Resolution Coordinator

$67,000-$75,000/year
Fully Remote
Monday-Friday, 8:00 AM-4:30 PM
Temp-to-Hire

Position Overview

The Prior Authorization Resolution Coordinator is responsible for investigating and resolving authorization issues, denials, and requests for additional information that delay approvals. This role works closely with clinicians, reviewers, internal teams, and families to maximize approval success rates and identify opportunities to improve processes.

This is an ideal opportunity for someone who enjoys analyzing denials, identifying patterns and trends, driving process improvements, and working independently in a fast-paced environment.

Key Responsibilities

• Manage authorization requests and resolve denial issues
• Analyze responses and identify documentation gaps
• Coordinate resubmissions, appeals, and supporting documentation
• Monitor denial trends and recommend improvements to increase approval rates
• Collaborate with clinicians, reviewers, family members, and internal stakeholders
• Maintain accurate records and workflows within internal systems
• Respond to funding and authorization inquiries professionally and promptly
• Present trends, case updates, and recommendations in leadership meetings
• Ensure compliance with applicable privacy and documentation standards

Qualifications

Required

• Bachelor's degree
• Minimum 3 years of experience in authorization, reimbursement, claims review, funding, or related healthcare administrative functions
• Strong written and verbal communication skills
• Excellent analytical and critical-thinking abilities
• Experience identifying trends and implementing process improvements
• Ability to work independently and manage performance metrics
• Strong multitasking and organizational skills
• High attention to detail and data accuracy

Preferred

• Experience with CRM platforms
• Appeals, authorization, reimbursement, or funding experience
• Experience analyzing approval and denial trends

Why Candidates Will Love This Opportunity

• Fully remote position
• Meaningful work that positively impacts individuals and families
• Collaborative and supportive team environment
• Employee ownership opportunities
• Career growth and advancement potential
• Leadership that values innovation and new ideas

Benefits During Contract Period

• Medical, Dental, and Vision coverage
• Hospital Indemnity coverage
• Accident & Critical Illness coverage
• Life Insurance and Short-Term Disability
• Earned Safe & Sick Time
• Employee discount programs

Benefits Upon Conversion

Health & Financial Benefits

• Employer-paid majority of employee medical premiums
• Employer contribution toward dependent coverage
• Dental Insurance
• Health Savings Account with employer contribution
• Company retirement contribution
• Employee ownership program

Ideal Candidate Profile

Someone with experience in:

• Prior authorizations
• Appeals and escalations
• Billing and reimbursement support
• Revenue cycle operations
• Claims review
• Funding and approval coordination
• Authorization analysis