Authorization Rep

Job Title: Authorization Representative
Job Location: Remote
Duration: 26 weeks
Shift: Day 5x8-Hour (09:00 - 17:00)

Description:
The Authorization Coordinator I supports the Central Authorization Optimization Program by processing referral and prior authorization requests, monitoring pending referrals, and documenting status updates accurately in Epic and related managed care systems. This role covers incoming phones, email escalations, and RightFax authorization requests to help reduce backlog, improve turnaround times, and support provider and patient access to care. The coordinator follows UM protocols, payer contract requirements, and standard work to complete requests within scope or route cases to nurses or physicians when needed. Candidates should be prepared to discuss specific examples of referral, authorization, documentation, payer follow-up, and issue-resolution experience in a remote setting.

Requirements:
Epic experience required
Experience with referral processing, prior authorizations, or utilization management workflows
Experience with CPT, HCPCS, ICD-9/ICD-10, medical terminology, and payer requirements
Ability to process incoming phones, email escalations, and RightFax authorization requests
Ability to monitor pending referrals and meet turnaround time standards
Proficiency in Microsoft Word, Excel, EMR documentation, and managed care systems
Ability to provide clear, detailed, and direct responses to situational workflow questions

Mandatory Skill:
EPIC Experience
Experience with referral processing, prior authorizations, or utilization management workflows
Experience with CPT, HCPCS, ICD-9/ICD-10, medical terminology, and payer requirements