Authorization Coordinator

Care Coordinator / Prior Authorization Specialist (Remote)

MUST live in California!

Do you thrive at the intersection of healthcare, problem-solving, and patient advocacy?

Do you enjoy keeping complex processes moving smoothly, ensuring patients get the care they need without unnecessary delays? If you're detail-oriented, compassionate, and experienced with referrals and prior authorizations, this role offers an opportunity to make a direct impact—every single day.

About the Role

The Care Coordinator plays a vital role in processing patient referral requests to ensure timely, accurate determinations aligned with utilization management protocols. Working within a defined scope of practice, you will independently complete referrals or route them to managed care physicians and nurses when clinical review is needed.

This position supports both patients and providers, answers referral status questions, meets strict turnaround times, and contributes to ongoing improvements in referral workflows. You'll be part of a large, award-winning, not-for-profit hospital system that values collaboration, quality, and service excellence.

What You'll Be Doing

• Process patient referrals in accordance with established standard work procedures and utilization management protocols.
• Review referrals with exceptional accuracy and attention to detail, ensuring appropriate handling and documentation.
• Monitor daily pending referrals to meet required timeliness standards and provide a high level of customer service.
• Proactively identify and escalate potential barriers or delays to supervisors and key stakeholders.
• Document referral actions, updates, and determinations clearly and consistently in the system.
• Gather and submit required medical documentation to support determinations with health plans and clinical reviewers.
• Ensure referrals comply with health plan contracts, medical necessity criteria, and policy requirements.
• Accurately record final determinations and outcomes according to standard work expectations.
• Assist patients and providers with questions regarding referral status, next steps, and expectations.
• Contribute insights and ideas to improve referral processes, workflows, and service quality.
• Adapt to changing workloads, special projects, and evolving priorities while supporting team needs.

What You Bring to the Role

Required Skills & Experience

• High school diploma or equivalent education and experience.
• Knowledge of medical terminology to accurately interpret and process referrals.
• Working knowledge of CPT, HCPCS, and ICD-9/ICD-10 coding.
• Experience with referrals and prior authorization processes, ideally in a managed care, health plan, or hospital environment.
• Understanding of health plan determinations and medical necessity documentation.
• Proficiency with EHR/EMR systems, including EPIC.
• Strong computer skills, including Microsoft Excel and Word.
• Ability to identify, investigate, and resolve referral or authorization issues.
• Clear, professional communication skills—written and verbal.
• Strong organizational and time-management abilities with comfort handling multiple priorities.

Preferred Qualifications

• Experience in utilization review or utilization management.
• Familiarity with managed care programs, policies, and workflows.
• Experience working directly with health plans and interpreting authorization requirements.
• Background in a large hospital system or complex healthcare setting.
• A customer-focused mindset with a commitment to supporting patients, providers, and internal partners.
• Interest in process improvement and workflow optimization.

Work Environment

• Fully remote position
• Monday–Friday schedule between 7:00 a.m. and 4:30 p.m.
• Occasional weekend work may be required, though rare
• Desk-based role with extensive use of EPIC, electronic systems, and standard office software
• Frequent interaction with providers, health plans, and internal teams via phone, email, and electronic messaging

Why This Role Is Worth Considering

• Make a meaningful impact on patient care access
• Join a mission-driven, award-winning not-for-profit healthcare system
• Work remotely with a stable weekday schedule
• Be part of a collaborative team that values accuracy, efficiency, and continuous improvement

Job Type & Location

This is a Contract position based out of Sacramento, CA.

Pay and Benefits

The pay range for this position is $24.00 - $24.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Jun 1, 2026.