Authorization Specialist – Healthcare Financial Clearance

Stanford Children's Health; Menlo Park (CA); On-site; USD 47,000 - 59,000; Full time

Job summary

Stanford Medicine Children's Health is seeking an Authorization Coordinator who will ensure financial clearance for scheduled services and serve as a resource on complex referral/authorization issues. You will provide high-quality customer service in line with PCARES practices and department regulations.

The role emphasizes collaboration with providers, tracking authorization statuses, and resolving payer issues to minimize financial risk while maintaining patient-focused care.

Qualifications

• Education: High school diploma or GED equivalent.
• Experience: Two years of directly-related experience.
• Licensure/Certification: None required.

Responsibilities

• Act as patient and family advocate between providers and payers' referral/authorization requirements.
• Collaborates with providers and staff to promote referrals and authorizations.
• Tracks and notes patient accounts on authorization status and payer issues; prioritizes urgent cases.
• Processes and follows up on denials, peer-to-peer or medical justification requirements.
• Follows up on authorizations requiring further research or resubmission.
• Ensures authorization claims edits are cleared timely per standards.
• Investigates, resolves and documents insurance issues with stakeholders as needed.
• Coordinates with contracting for letters of agreements for non-LPCH contracted coverage.
• Alerts management to possible deferrals/denials before service date.
• Communicates with access nurse or clinician for necessary triage.

Skills

Effective communication

Analytical thinking

Problem solving

Teamwork

Education

High school diploma or GED

Job description

Stanford Medicine Children's Health is seeking an Authorization Coordinator who will ensure financial clearance for scheduled services and serve as a resource on complex referral/authorization issues. You will provide high-quality customer service in line with PCARES practices and department regulations.

The role emphasizes collaboration with providers, tracking authorization statuses, and resolving payer issues to minimize financial risk while maintaining patient-focused care.