Authorization Coordinator I

As an Authorization Coordinator, you will play a vital role in streamlining patient care by managing referrals and securing prior authorizations. Working within Epic and leading managed care systems, you will handle inquiries across phone, email, and digital fax channels to reduce backlogs and maintain prompt turnaround times. You will review medical terminology and coding (CPT, HCPCS, ICD-10) against payer criteria, follow utilization management protocols, and collaborate with clinical teams to ensure patients receive essential care without delay. The ideal candidate is proactive, possesses exceptional attention to detail, and excels at solving complex authorization workflows independently in a remote setting. Responsibilities: • Process incoming referral and prior authorization requests received via phone, email, and RightFax. • Review clinical documentation, verify eligibility, and confirm authorization requirements using CPT, HCPCS, and ICD-10 codes. • Accurately document authorization statuses, notes, and patient records within Epic and managed care systems. • Track and monitor pending referrals to meet strict turnaround times and support timely access to care. • Troubleshoot authorization and referral discrepancies, escalating complex clinical cases to nurses or physicians as appropriate. Qualifications: • High school diploma or equivalent education/experience. • Proven proficiency with Epic EMR systems. • Practical background in referral processing, prior authorizations, or utilization management. • Knowledge of CPT, HCPCS, ICD-10 coding, and managed care payer policies. • written and verbal communication skills with the ability to manage multichannel queues (phone, email, fax). • Self-motivated and comfortable working independently in a remote setup.

salary: $24.45 - $24.46 per hour
shift: First
work hours: 9 AM - 5 PM
education: High School

Responsibilities

• Process incoming referral and prior authorization requests received via phone, email, and RightFax.
• Review clinical documentation, verify eligibility, and confirm authorization requirements using CPT, HCPCS, and ICD-10 codes.
• Accurately document authorization statuses, notes, and patient records within Epic and managed care systems.
• Track and monitor pending referrals to meet strict turnaround times and support timely access to care.
• Troubleshoot authorization and referral discrepancies, escalating complex clinical cases to nurses or physicians as appropriate.

Skills

• Epic experience
• referral processing
• authorizations, utilization

Qualifications

• Years of experience: 0 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.


Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.


Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.


We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.