Prior Authorization Coordinator Job at Robert Half (Minneapolis)

Patient Care Coordinator

Responsible for the coordination of appointments and support services for depart...

Location

United States , Albuquerque

Salary:

16.99 - 24.79 USD / Hour

UNM Hospitals

Expiration Date

Until further notice

Requirements

High School or GED Equivalent
2 years directly related experience
Medical Terminology Course w/in Six Months of Position (nonessential)
Bilingual English, Spanish, Keres, Tewa, Tiwa, Towa, Zuni, or Navajo (nonessential)

Job Responsibility

Responsible for the coordination of appointments and support services for departments/physicians
Interface with insurance companies and other payors on prior authorization and referral requests
Abstract charts and assign CPT, ICD-9 and HCPCS codes for purposes of obtaining prior authorization
Assist billing personnel with preparation of denials and submitting appeals for payment
Assist in resolving patient problems, concerns and complaints
serve as patient advocate and liaison
Ensure adherence to Hospitals and department policies and procedures
PATIENT CARE - Assist patients in locating departments
schedule and coordinate patient appointments
refer patients and families to appropriate services and resources

Fulltime

Referral & Prior Auth Rep IV

Leads and executes referral coordination and prior authorization workflows for A...

Location

United States of America , Rochester

Salary:

21.23 - 28.66 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

High School diploma or equivalent required
3 years of relevant experience required
1 year of demonstrated leadership experience required
2–3 years in referral/prior authorization or care coordination, including neurology or another complex specialty preferred
or equivalent combination of education and experience
Medical terminology preferred
EMR proficiency (e.g., appointment and imaging order workflows)
Knowledge of payer prior authorization processes
Strong communication and customer service
Organizational and critical thinking skills

Job Responsibility

Leads and executes referral coordination and prior authorization workflows for Adult Neurology, ensuring accurate, timely, and compliant processing of referrals, testing, procedures, and specialty visits
Oversees workqueue distribution, provides day-to-day guidance and escalation support, and serves as liaison among patients, providers, clinical teams, and payers
Drives access, quality, and financial outcomes by applying neurology-specific knowledge, optimizing workflows, and training staff on standard work and system use
Referral & Prior Authorization Management: Prepare, submit, and track prior authorizations for neurology specialty visits, and outgoing referrals
verify benefits
document determinations and follow-ups in the EMR
Workqueue, Throughput & Team Leadership: Monitor and assign referrals across multiple neurology workqueues
balance workload, set priorities, and provide real-time guidance and escalation support
delegate tasks to meet turnaround targets
Neurology Referral Coordination & Scheduling: Validate medical necessity and ICD-10/CPT details

Fulltime

Patient Care Coordinator

Responsible for the coordination of appointments and support services for depart...

Location

United States , Albuquerque

Salary:

16.99 - 24.79 USD / Hour

UNM Hospitals

Expiration Date

Until further notice

Requirements

High School or GED Equivalent
2 years directly related experience

Job Responsibility

Responsible for the coordination of appointments and support services for departments/physicians
Interface with insurance companies and other payors on prior authorization and referral requests
Abstract charts and assign CPT, ICD and HCPCS codes for purposes of obtaining prior authorization
Assist billing personnel with preparation of denials and submitting appeals for payment
Assist in resolving patient problems, concerns and complaints
Serve as patient advocate and liaison, interface with patients, families, staff and department/physicians
Serve as a role model to promote organizational values, a positive work environment and efficient, quality patient care
Ensure adherence to Hospitals and department policies and procedures
Patient care assignment may include neonate, pediatric, adolescent, adult and geriatric age groups

Fulltime