Role Description
We're looking for a Prior Authorization & Denials Specialist to join our growing team at The Coordinators! You'd be working remotely with our client in the Neurology space. In this role, you will own the prior authorization process while managing insurance denials for a busy neurology practice. You will:
• Obtain authorizations, investigate and resolve denied claims.
• Collaborate closely with clinical and front-office staff.
• Identify trends that improve reimbursement and reduce future denials.
• Work independently with minimal training.
Responsibilities
• Patient Onboarding & Intake
• Review upcoming services and obtain all required prior authorizations before patient appointments or procedures.
• Verify insurance requirements and ensure complete documentation is obtained before submitting authorizations.
• Communicate with providers and clinical staff regarding authorization requirements and missing information.
• Monitor authorization status and ensure approvals are received within required timeframes.
• Maintain accurate authorization documentation within Athena EMR.
• Revenue Cycle & Denials Management
• Review denied insurance claims and determine the root cause of each denial.
• Work denied claims through adjudication by gathering documentation, correcting errors, and resubmitting claims when appropriate.
• Contact insurance carriers to resolve denied or unpaid claims.
• Rebuild and resubmit claims through Athena EMR when necessary.
• Collaborate with providers and internal staff to obtain supporting clinical documentation.
• Identify denial trends and recommend workflow improvements to reduce recurring issues.
• Provide feedback to front-office and clinical teams to prevent future denials caused by registration, insurance, or documentation errors.
• Maintain accurate notes and documentation throughout the appeals and denial resolution process.
• Follow payer guidelines while maintaining HIPAA compliance.
Qualifications
• Athena EMR experience (required)
• Extensive prior authorization experience (required)
• Extensive insurance denial management experience (required)
• Experience working with commercial insurance plans, Medicare, and Medicaid
• Strong understanding of medical billing workflows and revenue cycle management
• Experience investigating and resolving claim denials through appeals and payer communication
• Ability to identify root causes rather than simply resubmitting claims
• Excellent written and spoken English with professional communication
• Strong organizational skills with exceptional attention to detail
• Able to prioritize multiple authorizations and denials simultaneously in a fast-paced environment
• Comfortable working independently with minimal training and supervision
• Tech-savvy and effective in a remote work environment
• High integrity and ability to handle sensitive patient information
• High ethical standards, professionalism, and respect in all patient interactions
• Willingness to learn, grow, and develop yourself professionally
Schedule
• Full-time, Central Time business hours
Pay Range
• $1,000–$1,400 per month (depending on experience)
Equipment
• BYO devices
How to Apply
Visit our careers page, submit your CV, and tell us why you'd be a great fit!
Company Description
The Coordinators is a staffing agency that connects healthcare A-Players with meaningful opportunities and strives for growth. If you're ready to make an impact in healthcare administration, we'd love to hear from you.
• Superb written and spoken English (we assess skills unassisted by AI tools, Grammarly, and ChatGPT).
• Entrepreneurial, attentive to others, curious, and hungry for growth.
You can learn more about The Coordinators at
coordinators.pro
or from our founder's YouTube podcast.