Prior Authorization Coordinator

Prior Authorization Coordinator – Responsibilities and Qualifications 

Key Responsibilities: 

• Review patient insurance policies to determine specific prior authorization requirements based on CPT codes for all upcoming surgical procedures. 

• Initiate prior authorization requests through provider portals, phone communication, or fax submission. 

• Track and follow up on submitted authorization requests, ensuring approvals are obtained and properly attached and linked to the patient’s scheduled appointment. 

• Prepare and submit appeals when authorization requests are denied or require reconsideration. 

• Communicate with patients when necessary to explain the prior authorization process or request additional required information. 

• Accurately document all prior authorization activities in patient charts to ensure the care team is informed prior to the patie...