Coordinator III - Prior Authorization

Cleveland Clinic; United States; Remote; USD 40,000 - 65,000; Full time

Job summary

Cleveland Clinic Health System in Cleveland is seeking a Coordinator III - Prior Authorization to join the Endocrinology-Medical Specialty Institute at the Main Campus. This role focuses on managing prior authorization processes, coordinating with patients and insurers to determine coverage, and supporting clinical teams with efficient workflow.

You will handle faxed requests, collaborate with insurance companies, and participate in monthly team activities, with a remote schedule that enables

Qualifications

• High school diploma or GED required.
• Five years of office experience preferred.
• Five years coordinating and assisting with management functions and special projects.

Responsibilities

• Coordinate all department support and clerical activities and serve as liaison with internal and external clients.
• Coordinate department activities by facilitating analysis and reporting information.
• Develop, maintain and distribute reports for schedules, budgets, staff, PTO and patient information.
• Prepare, provide analysis for and implement special studies and projects.

Education

High School Diploma or GED

Tools

CoverMyMeds

SureScripts

Epic

Job description

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.

Job Title

Coordinator III - Prior Authorization

Location

Cleveland

Facility

Cleveland Clinic Main Campus

Department

Endocrinology-Medical Specialty Institute

Job Code

U20005

Shift

Weekend Days

Schedule

7:00am-5:30pm

Job Details

Join Cleveland Clinic’s Main Campus where research and surgery are advanced, technology is leading-edge, patient care is world class and caregivers are family. Here, you will work alongside a passionate and dedicated team, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.

At Cleveland Clinic, everyone is a caregiver, including our essential administrative and non-clinical staff. All efforts are vital in helping us continue to provide the exceptional care our patients and communities expect.

As Coordinator III, your contributions will help advance this mission. In this role, you will oversee all activities within your department, ensuring organization and workflow, primarily handling faxed requests such as contacting patients regarding insurance issues and reaching out to insurance companies to determine third-party coverage. Your work is critical for the team, as you help create an environment that enables fellow caregivers to work efficiently and cohesively.

A caregiver in this position works a remote schedule consisting of four 10-hour shifts on Friday, Saturday, Sunday and Monday from 7:00 a.m. -- 5:30 p.m.

The role also requires meeting once per month, either at the Main Campus or an off-site location for team building.

A caregiver who excels in this role will:

• Coordinate all support and clerical activities for the department by providing support to internal clients while functioning as a liaison with external clients.
• Coordinate various department activities by facilitating analysis and reporting information.
• Develop, maintain and distribute reports for schedules, budgets, staff, PTO and patient information.
• Prepare, provide analysis for and implement special studies and projects.

Physical Requirements:

• Ability to perform work in a stationary position for extended periods
• Ability to operate a computer and other office equipment
• Ability to travel throughout the hospital system
• Ability to communicate and exchange accurate information
• In some locations, ability to move up to 20 pounds

Personal Protective Equipment:

• Follows standard precautions using personal protective equipment as required.

Preferred qualifications for the ideal future caregiver include:

• Prior experience with prior authorizations
• Experience with medications, infusions, or pre-access work.
• Familiarity with tools like CoverMyMeds, SureScripts and Epic
• Previous Epic experience

Minimum qualifications for the ideal future caregiver include:

• High School Diploma or GED
• Five years of office experience
• Five years of experience coordinating and assisting with management functions and special projects
• Proficient with spreadsheets, word processing and database software

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances.

Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.

If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/

Please review the Equal Employment Opportunity poster.

Cleveland Clinic is pleased to be an equal employment opportunity employer.