The Pre-Authorization Coordinator manages the complete front-end patient experience and revenue cycle operations. This hybrid role handles front-desk patient intake, check-in/check-out, and scheduling alongside complex
insurance verification, pre-certifications, pre-authorizations, and referral management. This position ensures exceptional patient service, accurate clinical scheduling, and timely payer approvals to optimize practice workflows and prevent financial denials.
Essential Duties and Responsibilities
Patient Services & Front Office (PSR Tasks)
• Patient Intake: Greet patients warmly, execute check-in/check-out procedures, and verify accurate demographic information.
• Appointment Scheduling: Coordinate, schedule, and reschedule patient appointments utilizing EHR scheduling workflows.
• Co-Pay Collection: Collect co-payments, past due balances, and self-pay fees at the time of service, issuing accurate receipts.
• Phone Management: Answer incoming multi-line phone calls, route messages to clinical teams, and address patient inquiries promptly.
• Check-Out Procedures: Process patient check-outs, schedule necessary follow-up visits, and distribute summary documentation.
Pre-Certification & Financial Coordination
• Insurance Verification: Confirm patient eligibility, benefit levels, and policy details prior to scheduled appointments.
• Prior Authorizations: Submit, track, and secure pre-certifications, pre-authorizations, and pre-determinations for medical/surgical procedures.
• Referral Management: Review and coordinate incoming and outgoing clinical referrals according to insurance guidelines.
• Payer Communication: Connect with insurance company representatives to resolve coverage issues, review policies, and track pending approvals.
• Data Entry & Management: Update authorization codes, effective dates, and policy boundaries accurately within office-management software.
• Clinical Review: Screen patient records to ensure documented medical necessity mirrors payer authorization rules.
• Patient Financial Counseling: Communicate out-of-pocket responsibilities, network status, and authorization delays clearly to patients.
• back-office administrative tasks simultaneously.
Education: High school graduate or equivalent.
Experience: Two-year minimum experience working with healthcare insurance, billing and coding.
Certifications: Computer skills: word processing, spreadsheet (Word, Excel), EPIC. Excellent written and verbal communication skills. Knowledge of current coding for CPT/ICD-10/HCPS. Medical terminology.
Preferred Certifications: Certification as Coding Specialist preferred.
Preferred Other:
From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us.
Our Mercy health system was founded by the Sisters of Mercy in 1986. But our heritage goes back more than 185 years. It began with an Irish woman named Catherine McAuley, who wanted to help the poor women and children of Dublin. Though Catherine had a modest upbringing, she received an unexpected inheritance that allowed her to fulfill her dreams. In 1827, she opened the first House of Mercy in Dublin, intending to teach skills to poor women and educate children. Many volunteers came to help. A few years later, Catherine founded the Sisters of Mercy, the first religious order not bound to the rules of the cloister, whose Sisters were free to walk among the poor and visit them in their homes. By the time Catherine died in 1841, there were convents in Ireland and England, and in 1843, the Sisters of Mercy came to the United States. In 1871, they traveled to St. Louis and from there throughout the Midwest, beginning what would, today be known as Mercy.
Mercy, named one of the top five large U.S. health systems in 2018, 2017 and 2016 by IBM Watson Health, serves millions annually. Mercy includes more than 40 acute care and specialty (heart, children’s, orthopedic and rehab) hospitals, 800 physician practices and outpatient facilities, 44,000 co-workers and 2,100 Mercy Clinic physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas. In addition, Mercy's IT division, Mercy Technology Services, supply chain organization, ROi, and Mercy Virtual commercially serve providers and patients in more than 20 states coast to coast.