Prior Authorization Resolution Coordinator

Prior Authorization Resolution Coordinator

$67,000-$75,000/year

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

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  Manage authorization requests and resolve denial issues
  
  



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  Analyze responses and identify documentation gaps
  
  



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  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
  
  



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  Present trends, case updates, and recommendations in leadership meetings
  
  



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  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
  
  



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  Excellent analytical and critical-thinking abilities
  
  



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  Experience identifying trends and implementing process improvements
  
  



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  Ability to work independently and manage performance metrics
  
  



• 
  Strong multitasking and organizational skills
  
  



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  High attention to detail and data accuracy
  
  

Preferred

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  Experience with CRM platforms
  
  



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  Appeals, authorization, reimbursement, or funding experience
  
  



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  Experience analyzing approval and denial trends
  
  

Why Candidates Will Love This Opportunity

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  Fully remote position
  
  



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  Meaningful work that positively impacts individuals and families
  
  



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  Collaborative and supportive team environment
  
  



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  Employee ownership opportunities
  
  



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  Career growth and advancement potential
  
  



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  Leadership that values innovation and new ideas
  
  

Benefits During Contract Period

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  Medical, Dental, and Vision coverage
  
  



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  Hospital Indemnity coverage
  
  



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  Accident & Critical Illness coverage
  
  



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  Life Insurance and Short-Term Disability
  
  



• 
  Earned Safe & Sick Time
  
  



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  Employee discount programs
  
  

Benefits Upon Conversion

Health & Financial Benefits

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  Employer-paid majority of employee medical premiums
  
  



• 
  Employer contribution toward dependent coverage
  
  



• 
  Dental Insurance
  
  



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  Health Savings Account with employer contribution
  
  



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  Company retirement contribution
  
  



• 
  Employee ownership program
  
  

Ideal Candidate Profile

Someone with experience in:

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  Prior authorizations
  
  



• 
  Appeals and escalations
  
  



• 
  Billing and reimbursement support
  
  



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  Revenue cycle operations
  
  



• 
  Claims review
  
  



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  Funding and approval coordination
  
  



• 
  Authorization analysis
  
  

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance.