Prior Authorization Coordinator

Job Description

Job Description

Our client is a fast-growing healthcare technology company building AI-driven software to reduce administrative complexity in the healthcare system. Their end-to-end platform empowers clinician entrepreneurs to launch, operate, and scale independent practices by pairing modern automation with robust operational infrastructure. Backed by more than $200M from top-tier investors, the company is transforming how providers manage their practices and deliver care.Role OverviewThe client is seeking a Prior Authorizations Lead to design, manage, and scale their prior authorization function. This role is ideal for an operator who excels at bringing structure to complexity, driving efficiency, and building systems that scale.The Prior Authorizations Lead will own the full authorization lifecycle-from intake and submission to payer follow-up and resolution-ensuring fast turnaround times and exceptional provider experience. The role requires a strategic, hands-on leader who can define workflows, streamline operations, and partner cross-functionally to leverage automation.Key ResponsibilitiesLead the end-to-end prior authorization process, including verification, documentation, submission, and payer follow-up.Build, optimize, and scale workflows to reduce turnaround times and increase authorization approval rates across multiple specialties.Partner with Product and Engineering to identify automation opportunities and develop tools that reduce manual work.Collaborate with RCM and Operations teams to ensure seamless handoffs across authorizations, billing, and care coordination.Develop and manage KPIs to track performance, identify operational bottlenecks, and drive continuous improvement.Train and manage internal team members and/or vendor partners to ensure consistent execution and compliance with payer guidelines.Maintain up-to-date knowledge of payer policies, clinical criteria, and regulatory changes that impact authorization processes.Build SOPs, playbooks, and documentation to support scaling into new states, payers, and clinical domains.QualificationsBachelor 's degree required5–8 years of experience in healthcare operations, prior authorization management, or related RCM rolesDeep understanding of payer requirements, medical necessity standards, and authorization workflowsProven ability to lead cross-functional initiatives and manage high-volume operational processesAnalytical, systems-oriented thinker with a track record of improving turnaround times and accuracyExperience with automation tools or EMR/EHR integrations is a plusAbility to work fully in-person, 5 days per week, in San Francisco or New YorkCompensationEstimated Salary: $100,000–$140,000Total compensation may also include stock options. Final compensation will depend on experience, qualifications, and other relevant factors.