Coordinator I - Prior Authorization & Appeals

Job Title: Coordinator I - Prior Authorization & Appeals
Location: Remote 02895 (Work from Home)
Duration: 6 Months+ (Possibility of Extension)
 
Pay Rate: $16/hr. on W2
 
Position Summary:
The Coordinator I, Prior Authorization & Appeals, performs non-clinical support tasks aligned with established policies, procedures, and regulatory requirements. Reporting to the Clinical Supervisor, this role ensures compliance with ERISA, CMS, Medicaid, and client-specific standards while supporting the team to meet business objectives and service level agreements. Exceptional customer service and accuracy are critical in this role.
 
Key Responsibilities:

• Sort and process incoming faxes and mail in compliance with departmental and client standards.
• Complete transactions accurately and promptly to meet or exceed client service level agreements.
• Review and ensure adherence to ERISA, CMS, Medicaid, and client-specific requirements.
• Collaborate with team members to achieve operational goals and maintain client satisfaction.
• Perform detailed data entry and maintain accurate documentation.

• 6 months to 1 year of data entry experience.
• Proficient in Microsoft Word and Excel.
• Strong problem-solving, analytical, written communication, and interpersonal skills.
• Ability to type 25–30 words per minute.
• Highly detail-oriented with excellent organizational abilities.

• 1 year of healthcare industry experience (hospital, managed care, physician office, PBM, etc.).
• Familiarity with prescription drug products, dosage forms, and usage.
• Knowledge of medical and/or pharmacy terminology.

• High school diploma or GED required.

• Work hours: Monday – Friday, between 7:00 AM – 8:00 PM CT (shifts may vary).
• Training hours: 8:00 AM – 4:30 PM CT.