Prior Authorization Coordinator Job at Robert Half (St. Louis Park)

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

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

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 Pharmacy Technician

The Patient Services Specialist I is responsible for initiating, researching, co...

Location

United States

Salary:

43700.00 - 62480.00 USD / Year

Cencora

Expiration Date

Until further notice

Requirements

CPhT required
Florida Pharmacy Technician License preferred
2+ years of directly related or relevant experience
Broad training in fields such as Medical Office Administration, Social Work, Medical Records/Billing, Benefit Verification, Patient Financial Services, Pharmacy, Nursing, or similar vocations generally obtained through completion of a 2-year Associate Degree, technical vocational training, or equivalent combination of experience and education
Bachelor's degree program preferred

Job Responsibility

Initiate, research, complete, submit, and track Patient Services Program applications for assigned facilities
Conduct benefit verification and complete necessary third-party prior authorizations, reimbursement activities, patient assistance, and copay program enrollments
Coordinate refill calls, perform documented adherence activities, and coordinate dispensing for specialty medications, high-cost prescriptions, and/or infusion medications for both the pharmacy and medical benefit
Proactively interact with facility staff, patients, payers, and patient assistance programs (PAP)
May need to adjust work schedule to support customers in different time zones
May need to work on Cencora Holidays
Occasional travel may be required
Perform patient onboarding, benefit verification, prior authorization, financial assistance and appeals processes
Provide services for a health system’s ambulatory pharmacy, specialty pharmacy and/or outpatient infusion center environment
Interact with patients and providers to obtain insurance benefits and patient information needed to request prior authorizations

What we offer

Medical
dental
vision care
comprehensive suite of benefits focusing on physical, emotional, financial, and social aspects of wellness
Support for working families which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave
Training programs
Professional development resources
Opportunities to participate in mentorship programs, employee resource groups, volunteer activities

Fulltime

Medicaid Prior Authorization Coordinator

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

Location

United States , Minnetonka

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Bachelor’s degree in a related field preferred
Experience working with Medicaid billing processes
Strong technical skills, including proficiency with computers and Microsoft Excel
familiarity with Eldermark and PointClickCare is an asset
Understanding of insurance claims and billing practices
Exceptional attention to detail and commitment to maintaining high accuracy
Capable of working independently as well as collaboratively within a team

Job Responsibility

Organize and maintain documentation and digital records for Medicaid service authorizations and billing rates
Make real-time updates to the billing system when resident information, authorization details, or fee structures change
Monitor expiring authorizations and initiate the renewal process to guarantee uninterrupted claims processing and reimbursement
Track and record relevant Medicaid data, including resident rosters, authorization periods, billable services, and financial obligations
Enter and reconcile incoming Medicaid payments within the billing platform
Prepare and process patient billing statements for required contributions under Medicaid guidelines
Communicate with Medicaid provider representatives to resolve billing issues, clarify authorization requirements, and obtain necessary documentation

What we offer

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

Prior Authorization Coordinator

Robert Half

Location:
United States , St. Louis Park

Category:
-

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 08, 2026

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Location:United States , St. Louis Park

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Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:February 08, 2026

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