Insurance Authorization Coordinator

Job Summary

Responsible for ensuring accurate and timely insurance authorizations for diagnostic imaging as well as surgical and in‑clinic procedures. Provides expertise in payer guidelines, coding conventions, and authorization processes to minimize delays and denials. Coordinates with providers, payers, and pre‑registration to validate eligibility, and secure approvals. Maintains compliance with institutional, state, and federal regulations while promoting service excellence and operational efficiency.

• Obtains prior authorizations for diagnostic imaging as well as surgical and in‑clinic procedures from insurance payers within required timelines.
• Reviews medical records and documentation to determine appropriate clinical information needed for authorization requests.
• Applies knowledge of ICD‑10, CPT, and HCPCS coding conventions to support accurate authorization submissions.
• Confirms patient eligibility and coverage through payer portals and systems to ensure service approval.
• Monitors payer guideline updates, and communicates changes to providers and staff.
• Maintains HIPAA compliance and safeguards patient information when handling clinical and financial data.
• Resolves escalated authorization issues by collaborating with providers, payers, and patients to identify alternatives.
• Participates in quality assurance, training, and professional development activities.
• Performs other duties as assigned.

High school diploma or equivalent.

2–3 years of experience. An equivalent combination of education and experience may be considered. All experience must be paid and in the same related field. Part‑time and PRN experience will be prorated based on hours worked per week. Volunteer work and internships for academic credit are not counted.

N/A

Physical demands include:

• Lifting, pushing, or pulling objects up to 50lb: occasional (