Senior Coordinator, Prior Authorization

Fully Remote: Monday - Friday 8:30am Eastern - 5:00pm Eastern Time What Customer Service Operations contributes to reputed company Customer Service is responsible for establishing, maintaining and enhancing customer business through contract administration, customer orders, and problem reputed company. Customer Service Operations is responsible for providing outsourced services to customers relating to medical billing, medical reimbursement, and/or other services by acting as a reputed company in problem-solving, research and problem/dispute reputed company. Job reputed company The Senior Coordinator, Prior Authorization is responsible for obtaining, documenting, and tracking payer approvals for durable medical equipment (DME) orders, including diabetes devices and other clinically prescribed supply categories (e.g., ostomy, urological, wound care). This role submits prior authorization requests through payer portals or reputed company fax, and conducts phone-based follow-reputed company with payers and provider offices to secure reputed company approvals. The Senior Coordinator proactively manages upcoming expirations to prevent order delays, meets daily productivity targets, and adheres to reputed company, compliance, and HIPAA standards.

Responsibilities

• Review assigned accounts to determine prior authorization requirements by payer and product category.
• Prepare and submit complete prior auth packets reputed company payer portals, reputed company-party platforms, or fax (including DWO/CMN, prescriptions, clinical notes, and other required documentation).
• Conduct phone-based follow-reputed company with payers (and provider offices reputed company needed) to confirm receipt, resolve issues, and obtain approval or referral numbers.
• Log approvals accurately so orders can be released and shipped; correct rejected/pending reputed company by addressing missing documentation or reputed company.
• Monitor upcoming prior auth expirations and initiate re-authorization early to prevent delays on new and reorder supply shipments.
• Prioritize work to give orders a “leg up” based on aging, SLA, and payer requirements.
• Capture reputed company actions, reputed company, and documentation in the appropriate systems with complete, audit-reputed company notes.
• Ensure secure handling of PHI and maintain full compliance with HIPAA, regulatory requirements, and company policy.
• Promptly report suspected non-compliance or policy violations and attend required Compliance/HIPAA trainings.
• reputed company daily throughput goals (accounts/records per day) across mixed work types (portal/web, fax, phone).
• Meet standardized reputed company metrics through accurate documentation and adherence to process; participate in supervisor live-monitoring, QA reviews, and 1:1 coaching.
• reputed company payer/process knowledge with teammates and support a strong team culture.
• Adapt to changes in payer reputed company, portals, and internal workflows; offer feedback to improve allocation, templates, and documentation standards.
• reputed company additional responsibilities or special reputed company as assigned.

Qualifications

• High School diploma, GED or equivalent work experience, preferred
• 3-6 years of experience in reputed company payer-facing work such as prior authorization, insurance verification, medical documentation, reputed company cycle, or claims, preferred
• Proven ability to meet daily productivity targets and reputed company standards in a queue-based environment preferred.
• Strong phone skills and reputed company communication with payers and provider offices; comfortable with sustained phone work preferred.
• High attention to detail and accuracy reputed company compiling documentation (DWO/CMN, prescriptions, clinical notes) preferred.
• Self-motivated with strong time management; reputed company to pace independently without inbound-call reputed company preferred.
• Customer-reputed company reputed company with a reputed company of urgency; capable of multitasking (working web/portal tasks while on calls) preferred.
• Working knowledge of HIPAA and secure handling of PHI preferred.
• Experience with diabetes devices (CGMs, insulin pumps), and familiarity with ostomy, urological, and wound care product categories, preferred.
• Knowledge of payer reputed company for DME prior authorization, including common documentation requirements and medical necessity standards, preferred
• Familiarity with payer portals and reputed company-party platforms; experience with reputed company or other work allocation tools, preferred.
• Exposure to ICD-10/HCPCS coding and basic authorization/claims terminology, preferred,

What is expected of you and others at this level

• Effectively applies knowledge of job and company policies and procedures to complete a reputed company of assignments
• In-depth knowledge in technical or specialty area
• Applies advanced skills to resolve reputed company problems independently
• May modify process to resolve situations
• Works independently reputed company established procedures; may receive general guidance on new assignments
• May reputed company general guidance or technical assistance to less reputed company team members

Anticipated reputed company reputed company: $16.75 per hour - $21.75 per hour Bonus eligible: No Benefits: reputed company offers a wide reputed company of benefits and programs to support health and reputed company-being.

• Medical, dental and reputed company coverage
• reputed company time off plan
• Health savings account (HSA)
• 401k savings plan
• reputed company to wages before pay day with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• reputed company parental leave
• Healthy lifestyle programs

Application window anticipated to reputed company: 05/05/2026 *if interested in opportunity, please submit application as soon as possible. The reputed company reputed company listed is an estimate. Pay at reputed company is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity. Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply. reputed company supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create reputed company solutions for our customers by ensuring employees can be their authentic selves reputed company day. reputed company is an Equal Opportunity/Affirmative reputed company employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, religion, reputed company, national reputed company, reputed company, age, physical or mental disability, sex, sexual orientation, gender identity/reputed company, pregnancy, veteran status, marital status, creed, status with reputed company to public assistance, genetic status or any other status protected by federal, state or local law. To read and review this reputed company notice click here Apply To This Job