Coordinator, Authorizations

Coordinator, Authorizations

Summa Care - 1200 E Market St, Akron, OH

Remote After Training - LOCAL

Summary
:
Collaborates across a broad continuum of care to assess, plan, implement, coordinate, monitor and evaluate services to determine coverage for a specific benefit plan and/or the need for prior authorization. Utilizes extensive knowledge of benefit plans, network/provider groups, medical coding, authorization processes, claims and provides excellent customer service utilizing interpersonal and de-escalation skills. Performs administrative tasks which include, but are not limited to, working with utilization physicians and nurses, medical offices and hospitals to identify services requiring authorization, out of network benefits and requirements, being knowledgeable of procedures, claims coding, and medical coding.
Investigates benefit plan detail by completing work boards and using numerous health plan computer applications related to benefits, claims, coding, and authorizations. Informs management of issues during authorization process.

Formal Education required
:

• Associate’s Degree in healthcare, business, finance/accounting, or related field or equivalent combination of education and/or experience.

Experience & Training Required
:

• Two (2) years of customer service experience to include resolving problems and/or disputes, data entry, billing, and/or authorizations in a utilization, home health, behavioral health, community or health plan setting; healthcare /claims experience preferred.

Other Skills, Competencies and Qualifications
:

• Knowledge of medical terminology.
• Basic knowledge of ICD-10, CPT, HCPCs codes.
• Typing of 35 Words per Minute with 96% accuracy rate.
• Problem Solving/Critical thinking/Analytic skills to interpret data and information with excellent attention to detail.
• Exhibits strong customer service focus and interpersonal skills.
• Excellent written and verbal skills.
• Excellent telephone skills with a variety job classifications and customers. This includes accurate and timely message delivery and/or follow-up.
• Basic computer skills needed to collect, assess, and enter data.
• Ability to deescalate stressful situations.
• Proficient using Microsoft Outlook and Word. Knowledge of Excel, and PowerPoint helpful.
• Ability to prioritize workload to appropriately match focus to clinical urgency, regulatory requirements, volume fluctuations, and cyclical business needs.
• Work cooperatively with team members to accomplish organization’s mission and goals.
• Maintain confidentiality of member health and business information.
• Organization and time management skills to accurately complete tasks within designated periods in fast-paced environment.
• Understand and comply with regulatory requirements as well as policies/procedures.
• Flexible: ability to adjust work hours to meet business demands.
• Ability to effectively interact with populations of members/customers with an understanding of their needs for self-respect and dignity.

Level of Physical Demands
:

• Sit and/or stand for prolonged periods.
• Bend, stoop, and stretch.
• Lift up to 20 pounds.
• Manual dexterity to operate computer, phone, and standard office machines.

Based in Akron, Ohio, Summa Care provides Medicare Advantage, individual and family and commercial insurance plans. Summa Care has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, Summa Care is committed to building lasting relationships.

Employees can expect competitive pay and benefits.

Equal Opportunity Employer/Veterans/Disabled

$19.23/hr - $23.08/hr

The salary range on this job posting/advertising is base…