Prior Authorization Coordinator Job at Robert Half (Minneapolis)

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

Prior Authorization Coordinator

We are looking for a dedicated Prior Authorization Coordinator to join our team ...

Location

United States , St. Louis Park

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proven experience in medical billing and prior authorizations within a healthcare setting
Strong understanding of insurance verification processes and claims management
Familiarity with Epic EMR system for documentation and tracking purposes
Excellent organizational skills and attention to detail in handling patient accounts
Ability to communicate professionally with patients, providers, and insurance representatives
Knowledge of healthcare regulations and compliance standards
Problem-solving skills to address billing and authorization challenges
Ability to work independently and collaboratively in a fast-paced environment

Job Responsibility

Process and manage prior authorization requests with accuracy and efficiency
Verify insurance coverage and eligibility to ensure proper billing procedures
Handle medical claims submissions and follow up on outstanding claims
Collaborate with healthcare providers to resolve patient account inquiries
Utilize Epic EMR to document and track patient information and authorization statuses
Investigate and resolve issues related to medical collections and billing discrepancies
Maintain compliance with healthcare regulations and insurance policies
Communicate effectively with patients regarding their account status and authorization requirements
Work closely with insurance companies to expedite approvals and resolve any delays
Provide support in analyzing patient account data to identify trends and areas for improvement

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Insurance Authorization Coordinator

We are looking for a detail-oriented and organized Insurance Authorization Coord...

Location

United States , Minneapolis

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

1–3 years of experience in prior authorization, medical billing, insurance verification, or similar healthcare roles
Comprehensive knowledge of commercial insurance, Medicaid, Medicare, and payer-specific processes
Proficiency in healthcare systems such as Epic, Cerner, or Athena, along with experience using payer portals
Strong communication skills and exceptional customer service abilities
High level of attention to detail and excellent organizational skills
Ability to analyze clinical documentation and understand medical terminology
Experience with high-volume data entry and administrative tasks
Familiarity with insurance verification processes and scheduling operations

Job Responsibility

Review provider orders, clinical records, and insurance guidelines to assess prior authorization requirements
Monitor pending authorizations and follow up to secure timely approvals
Communicate effectively with providers, clinical staff, patients, and insurance representatives to provide updates or request additional documentation
Accurately record all actions, communication, and outcomes related to authorizations within internal systems
Confirm patient insurance coverage and validate benefit eligibility
Identify and report authorization issues or payer-specific trends to management
Assist with appeals and reconsideration processes for denied authorizations
Stay informed about payer regulations, medical necessity standards, and insurance protocols
Collaborate with billing and revenue cycle teams to ensure accurate authorization data is included with claims

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Pharmacy Access Representative III

Manages medication coordination and removal of barriers that prevent patients fr...

Location

United States of America , Rochester

Salary:

21.71 - 29.31 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree in a Medical, Secretarial or related field and 4 years of relevant experience required
Or equivalent combination of education and experience
Capable of working independently with minimum supervision required
Strong communication skills, problem-solving abilities, and professional presentation required
Demonstrated customer relations skills required
Ability to multi-task, manage many details with accuracy, work under pressure, and maintain a professional attitude required
Completed ASHP-accredited training program or equivalent experience as a pharmacy technician upon hire preferred
Certification from a nationally accredited pharmacy technician certification program (Currently PTCB) and maintain ongoing education requirements upon hire preferred

Job Responsibility

Manages medication coordination and removal of barriers that prevent patients from receiving their medications
Communicates with the prescriber's office to acquire necessary information to submit prescriptions to the patient's insurance for approval including prior authorization, and helps enroll patients in financial assistance programs and arrange timely delivery of the medication
Facilitates communication between the patient, pharmacist, insurance, and staff to ensure coordinated care
Maintains expertise on all potential patient assistance programs (PAP), grants, foundations, and coupons relevant to the high-cost drugs prescribed in their assigned area(s)
Analyzes patients that are receiving high-cost medications for potential participation in PAPs, and identifies the best options for the patient given their overall circumstances
Coordinates with the patient and/or family to obtain necessary information, including income information and other personal details, as well as to present PAP options to the patient/family when there are multiple options
Enrolls patients in PAPs using the needed permission and information, follows up to determine the status of the application, and ensures proper documentation of this process
Submits all required documentation to the PAP throughout the duration of treatment to verify that payment for each prescription refill is still active
Understands and manages the payment process specific to each PAP, and ensures that payments are properly accounted for the correct patient and correct patient encounter
Meets or discusses with the patient and/or family the status of PAP eligibility on an as-needed basis if coverage changes during treatment duration

Fulltime

Rn-prior authorization/referral procedure and insurance coordinator

RN, Prior Authorization/Referral/Procedure and Insurance Coordinator functions a...

Location

United States , Des Moines

Salary:

Not provided

IntelyCare

Expiration Date

Until further notice

Requirements

Graduate of an accredited school of nursing or IA Board of Nursing approved nursing program
Current licensure in good standing to practice as a Registered Nurse in Iowa
Valid driver's license
Basic Life Support (BLS) ceritification or obtain certification within three months from date of hire
Mandatory Report Certification
Two (2) years of RN experience

Job Responsibility

Coordinates and develops ongoing patient care, including appointments, communication, and instruction
Function as a clinician, educator and resource for patients within their specialty of care
Assist provider and clinical staff with patient prep for examinations, treatments, and minor clinic procedures
Delivers high quality care utilizing the nursing process while demonstrating knowledge and clinical skills in accordance with established policies, procedures, and standards of care throughout the clinic and across the health care continuum
Maintain flexibility by demonstrating an ability and willingness to perform a variety of duties and accept changes or additions to assignments
Thoroughly understand testing (lab and procedures) values and relationship to patient status with accountability to take next steps, as appropriate to scope and licensure
Utilize critical thinking in making independent judgements and maintains responsibility and accountability for the knowledge of conditions of assigned patients
Builds and maintains positive working relationships with patients, physicians, and all others
Perform other duties as requested by Manager of Oncology Services to facilitate the smooth and effective operations of the hosp/clinics
Maintains knowledge of clinical protocols to facilitate timely and complete work up of patients

What we offer

paid time off
parental leave
401K matching
employee recognition program
Dental and health insurance
paid holidays
short and long-term disability
pet insurance
Early access to earned wages with Daily Pay
tuition reimbursement

Fulltime

New

Insurance Referral Coordinator

Location

United States , Seattle

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Prior experience handling referrals, prior authorizations, and insurance verification within a healthcare setting
Hands-on proficiency with Epic is required
Strong organizational skills with the ability to manage multiple active cases and deadlines at once
High attention to detail when reviewing documentation, entering information, and tracking approvals
Effective verbal and written communication skills for working with patients, providers, and insurance representatives
Ability to schedule appointments and support patients through administrative care coordination tasks
Familiarity with routine medical billing and insurance processes is preferred

Job Responsibility

Manage incoming referral requests and move each case through the required review and approval steps for specialty and support services
Secure payer authorizations and coverage verification for consultations, diagnostic testing, medications, medical equipment, home-based care, and other ordered services
Arrange appointments and coordinate related services to help maintain an efficient and consistent patient care experience
Answer patient inquiries involving standard insurance and billing topics, offering clear and accurate information
Educate patients on referral status, approval requirements, and next steps so they understand how to access authorized services
Support the acquisition or rental coordination of medically necessary equipment tied to patient care plans
Record referral activity, authorization updates, and case details accurately within Epic and other required documentation systems
Collaborate with clinical and administrative teams to keep referral workflows organized and ensure services are delivered without unnecessary delays

What we offer

Medical insurance
Vision insurance
Dental insurance
Life and disability insurance
401(k) plan

Fulltime

Outpatient Access Representative III

Coordinates activities of Outpatient Access employees. Acts as a resource to sta...

Location

United States of America , Rochester

Salary:

19.08 - 25.77 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

High School diploma and 2 years' experience in an administrative capacity or customer service field required
Medical terminology experience required
Demonstrated customer relations skills preferred

Job Responsibility

Coordinates activities of Outpatient Access employees
Acts as a resource to staff performing functions in a clinic setting
Monitors and ensures all functions are completed accurately, efficiently, and in a customer friendly manner
Coordinates all staff training activities
Assists clinic leadership through various aspects of operational support
May assist with lead duties such as personnel related matters, including performance evaluations
May be the front office eRecord superuser
Assist with workflow design and implementation
Serve as the front office expert supporting referral coordination, prior authorizations
Be assigned as main provider support

Fulltime

Prior Authorization Coordinator

Robert Half

Location:
United States , Minneapolis

Category:
Customer Service

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
May 03, 2026

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Job Description:

Job Responsibility:

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