Job Description
Job Description
The Prior Authorization Coordinator manages specific processes within the patient order. This position is responsible for checking status of authorizations/appeals with payers and contacting clinicians to obtain appropriate sign off to progress the patient’s order towards fulfillment.
Responsibilities
- Follow up on the status of authorization requests, including initial submissions and any subsequent prior authorization appeals.
- Review clinician documentation for completeness and appropriate signatures and partner with clinics to obtain required information.
- Serve as a liaison between the company, clinicians, healthcare teams, and patients to support order progression from intake to shipment.
- Maintain accurate patient records, payer portal registrations, and internal databases in compliance with policies and regulations.
- Meet departmental service levels, including turnaround time, while participating in team trainings and meetings.
- Support team collaboration and continuous process improvement with a focus on accuracy, efficiency, and patient experience.
- Other duties as assigned.
Qualifications
Education & Experience
Required:
- High school diploma or equivalent and relevant work experience
- 1+ years’ experience in a medical device, customer service, or call center type role.
Preferred:
- Previous experience in working with patients, clinicians, and payers.
- Previous experience working with Filemaker or Parachute.
- Previous medical device (outpatient DME), insurance, revenue cycle management, reimbursement, or customer service experience.
Knowledge & Skills
- Ability to accurately enter and review patient order information to ensure data integrity and compliance with established protocols.
- Capacity to effectively prioritize tasks and manage workload to meet deadlines and productivity targets in a fast-paced environment.
- Clear and concise verbal and written communication skills to interact with team members, healthcare professionals, and patients professionally and with empathy.
- Flexibility to adjust to changing priorities, processes, and procedures required to support the needs of the department and organization.
- Willingness to work collaboratively with colleagues to achieve common goals and provide support as needed to ensure the smooth functioning of the team.
- Ability to identify and resolve routine issues or escalate them appropriately to ensure timely resolution and minimize disruption to order processing workflows.
- Dedication to delivering high-quality service to internal and external customers by addressing inquiries, concerns, and requests promptly and courteously.
- Proficiency in using computer systems and software applications relevant to order management tasks, with a willingness to learn and adapt to new technologies as needed.
- Understanding of and commitment to adhering to relevant regulations, policies, and procedures governing patient order management activities.
- Demonstrated professionalism and integrity in handling confidential patient information and representing the organization positively in all interactions.