Patient Authorization Specialist (Remote)

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

Job summary

Stanford Medicine Children's Health in Menlo Park, CA, seeks an Authorization Coordinator to ensure financial clearance for scheduled services. You will advise on authorization questions and serve as a role model in customer service, aligning with PCARES practices and hospital policies.

Reporting to management, you will work with multiple departments to obtain timely authorizations, manage denials, and minimize financial risk while supporting high-quality care for children and families.

Qualifications

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

Responsibilities

• Act as a patient and family advocate between providers and payers' referral/authorization requirements.
• Collaborates with providers and staff to obtain referrals and authorizations.
• Tracks patient accounts on authorization status and supports urgent cases.
• Processes authorizations with denials or additional medical justification requirements.
• Follows up on authorizations needing further research or resubmission.
• Ensures claims edits are cleared timely per department standards.
• Investigates and resolves insurance issues with stakeholders as needed.
• Coordinates with contracting for letters of agreement for non-LPCH coverage.
• Alerts Authorization Manager of potential deferrals/denials before service date.
• Communicates with access nurse/clinician for triage and issue resolution.

Skills

Patient advocacy

Communication skills

Team collaboration

Problem solving

Medical terminology

Education

High school diploma or GED

Job description

Stanford Medicine Children's Health in Menlo Park, CA, seeks an Authorization Coordinator to ensure financial clearance for scheduled services. You will advise on authorization questions and serve as a role model in customer service, aligning with PCARES practices and hospital policies.

Reporting to management, you will work with multiple departments to obtain timely authorizations, manage denials, and minimize financial risk while supporting high-quality care for children and families.