Authorization Coordinator

Overview

Opportunities for you!  

• Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek 

• Free Continuing Education and certification

• Tuition reimbursement, education programs and scholarships 

• Vacation time starts building on Day 1, and builds with your seniority 

• Free money toward retirement with a 403(b) and matching contributions 

• Great food options with on-demand ordering 

• Free parking and electric charging 

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. 

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page. 

Responsibilities

The Authorization Coordinator is responsible for researching, verifying, and reviewing members' eligibility for all prior authorization (PA) requests received in the Utilization Management (UM) department. Uploads member demographics, processes prior and auto authorizations, follows up with providers for additional information, and redirects out of network requests. Facilitates the PA process as well as communicates authorization status to physician's office and members. Ensures that services are provided in a timely and cost-effective manner per UM policy and procedure. 

• Work Schedule: Monday through Friday, 8:00 AM – 5:00 PM (aligns with standard business hours). 
• Key Traits for Success: Candidates must be flexible and fluid. The health plan space changes rapidly and is rarely strictly "black and white," so adaptability and teamwork are crucial
• Daily Workflow: Highly sedentary and repetitive. The coordinator will spend most of the day sitting in front of a computer screen reviewing and processing authorizations. 
• Training & Onboarding: Initial onboarding training takes 3 to 6 months to fully understand the processes. The team will provide ongoing support throughout and after this period. 
• Accountabilities:
  • Research and process prior authorization requests.
  • Verify eligibility and benefits of members.
  • Perform data entry, prioritizes, and processes auto authorizations.
  • Monitor and follow-up on open or pended authorizations.
  • Enter demographic information into the system and update information.
  • Prepare and maintain logs and reports.
  • Respond to and process urgent/stat authorization requests.
  • Maintain confidentiality and discretion in use of member information.

Qualifications

Education:

• High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required

Experience: 

• 1 year of customer service or related experience required
• Word processing and computer experience required
• Background in a health plan, IPA, or TPA environment. 
• Knowledge of HMO Commercial insurance. 
• Familiarity with medical terminology and various health insurance products/requirements. 
• Experience with QNXT systems (not required to be an expert, but knowledge of the system/process is a plus). 
• Prior experience handling prior authorization and the referral process. 

Disclaimers

• Pay ranges listed are an estimate and subject to change.• If any bonuses are noted, they are only applicable to external hires meeting criteria.