Authorization Coordinator I - REMOTE

Authorization Coordinator I

Software Guidance & Assistance, Inc., (SGA), is searching for an Authorization Coordinator I for a Contract assignment with one of our premier Healthcare clients working remotely.

Responsibilities:

• The Authorization Coordinator I processes patient referral requests to support timely and accurate determinations. This role reviews referrals according to standard work, health plan contracts, and utilization management protocols, forwarding requests to nurses or physicians when required.
• The coordinator monitors pending referrals, maintains turnaround-time standards, documents referral updates and determinations, and assists providers and patients with status questions.
• The position requires strong attention to detail, medical terminology knowledge, and effective communication of medical concepts and issues.
• The coordinator also identifies workflow problems, reports anticipated delays, and supports process improvements. Success requires organized remote work habits, sound judgment, adaptability, and the ability to manage changing priorities while maintaining accuracy.

Required Skills:

• MUST HAVE EPIC EXPERIENCE
• 1+ year experience in healthcare administration, referrals, authorizations, or managed care
• Experience processing referrals according to protocols, health plan requirements, and turnaround times
• Proficiency in medical terminology and healthcare workflows
• Experience with Microsoft Excel, Word, and managed care systems
• Ability to document referral status and determinations accurately
• Ability to identify, understand, and resolve referral-related issues

Preferred Skills:

• Experience in a health plan, medical group, or utilization management setting
• Knowledge of CPT, HCPCS, and ICD-9 coding
• Experience obtaining medical information for authorization determinations
• Experience monitoring pending referrals and escalating anticipated delays

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