Authorization Coordinator
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Authorization Coordinator securing referrals, financial clearance, and insurance approvals for Lucile Packard Children’s Hospital Stanford. Resolving payer issues and supporting patient access.
Responsibilities:
- Provide day-to-day financial clearance of scheduled services assigned to the Authorization department work queues
- Serve as a resource for departments on complex referral and authorization issues and problem resolution
- Advise on authorization-related questions
- Provide high-quality customer service according to Hospital PCARES practices and department regulations, policies and procedures
- Act as a patient and family advocate by obtaining necessary provider information and fulfilling payer referral and authorization requirements
- Collaborate with providers and service-site staff to obtain referrals and authorizations
- Track and document patient accounts, authorization status, follow-up actions and payer issues
- Help prioritize clinically urgent cases and secure authorizations in advance to minimize financial risk
- Process and follow up on denied authorizations, peer-to-peer requests and further medical justification requirements
- Research, review and resubmit authorizations as needed
- Clear authorization claims edits holding claims according to department metrics and standards
- Investigate, resolve and document insurance issues and contact relevant stakeholders
- Coordinate with contracting to obtain letters of agreement for patients with non-contracted coverage
- Inform the Authorization Assistant Manager of potential deferrals or denials of elective/non-emergent services
- Communicate with access nurses and clinicians for triage and insurance issue resolution
Requirements:
- High school diploma or GED equivalent
- Two years of directly-related experience
- Ability to analyze operational and procedural problems and develop, recommend and evaluate proposed solutions
- Ability to speak and write effectively at a level appropriate for the job
- Ability to work well with individuals at all levels of the organization
- Knowledge of computer systems and software used in the functional area
- Knowledge of Medical Terminology
- Knowledge of Medicare, Medi-Cal, Workers Comp, Managed Care (HMO, PPO, POS, etc.), Children's Health Programs (CCS, GHPP, Healthy Families, etc.)
- No licensure or certification required
- Must comply with Joint Commission requirements, hospital policies and procedures, safety and quality programs, National Patient Safety Goals, licensure and health screenings
Benefits:
- Benefits eligible
- Full-time employee position
- Continuing education
- State-of-the-art facilities
- Reasonable accommodations for individuals with disabilities
- Equal opportunity and non-discrimination
- Employee referral amount: $375
Similar Jobs
Appeals Specialist II
Appeals Specialist II processing complex health insurance appeals for HCSC. Responding to member inquiries and supporting compliance with federal, state, and NCQA requirements.
Child Care Policy Specialist
Child care policy specialist shaping federal guidance, legislation, and reports for the Administration for Children and Families. Supporting states, territories, tribes, grantees, and Congressional policy requests.
Técnico/a Comercial – Suministros Agrícolas
Técnico/a comercial captando clientes agrícolas y vendiendo soluciones de riego e invernaderos. Rol remoto en Extremadura para cliente de Reclut, marketplace de reclutamiento con IA.
Histologist
Remote CRA I training as a Histologist for ICON’s sponsor-dedicated clinical trials. Monitoring studies, maintaining documentation, and supporting patient safety and regulatory compliance.
Senior External Audit Specialist
External audit specialist leading group benefit, BCBSA, and contractual compliance audits for Capital Blue Cross health insurance operations. Coordinating auditors, documentation, corrective actions, and executive reporting.
Medical Infocomm Specialist – Medical Aesthetics
Medical aesthetics specialist delivering product education, customer support, and project execution for AbbVie’s aesthetics portfolio in Wuhan, China.
Health Services Specialist
Health Services Specialist coordinating provider and member healthcare requests for Comagine Health, a nonprofit healthcare consulting organization. Managing documentation, authorizations, records, and non-clinical care coordination remotely in Washington State.
A/R Management Specialist
A/R specialist managing insurance, patient billing, appeals, and collections for Digitech, a provider of outsourced EMS billing and technology services.
Barrister
Barrister handling civil litigation advocacy and tailored client services for DAC Beachcroft’s integrated in-house chambers. Supporting fellow barristers and delivering advisory, drafting and advocacy work.
Medical Information Specialist, Italian, English
Medical Information Specialist providing Italian- and English-language healthcare product information and customer support. Handling inquiries, compliance processes, and medical information for Conduent’s clients.
Income Development Specialist – Automotive F&I
Income Development Specialist driving F&I sales growth for Safe-Guard’s automotive protection platform. Training dealer personnel and improving product sales, compliance, and profitability.
Mortgage Servicing Specialist II
Mortgage servicing specialist monitoring sub-servicers, collections, foreclosure, bankruptcy, and escrow compliance. Supporting borrowers and branches for SWBC, a financial services company.
Computational Biologist I
Computational Biologist developing Freenome’s multiomics, blood-based cancer screening assays. Applying bioinformatics and statistics to diagnostic development and FDA-regulated validation.
Medical Specialist
AbbVie immunology medical specialist promoting medicines and engaging healthcare professionals in Wenzhou. Supporting compliant market execution and adverse-event reporting.
Vaccines Specialist, Health and Science Professional
Pfizer Vaccines Specialist promoting the Vaccines Portfolio across Richmond-area healthcare customers. Driving territory sales through live and virtual engagement, account development and formulary access.
Nutrition Specialist
Nutrition Specialist coaching patients through personalized nutrition, metabolic health, and behavior strategies. Supporting Early Medical’s virtual longevity practice with data-driven care.
Global Biomarker Lead
Leading oncology clinical biomarker strategy and execution at Amgen. Advancing biomarker-driven development of innovative medicines through clinical research and cross-functional collaboration.
Site Selection Lead
Site Selection Lead securing data centers for Andromeda’s AI compute infrastructure platform. Owning market screening, technical diligence, lease negotiation, and delivery handoff across US markets.
Shop & Creator Coordinator
Remote TikTok Shop & Creator Coordinator running Panda Drum’s UGC creator pipeline. Growing TikTok Shop affiliate sales for the DTC steel tongue drum brand.