Remote Authorization Coordinator - Healthcare Pre-Cert

Work from Home; Nashville (TN); Remote; USD 42,000 - 61,000; Full time

Benefits offered by this job

Comprehensive benefits

Wellbeing support

Time away from work (PTO)

401(k) Plan with company match

Education assistance

Dependent scholarships

Job summary

HCA Healthcare is hiring an Authorization Coordinator to work from home, supporting timely pre-certifications and authorizations across payors. You will collect clinical data, apply authorization criteria, and monitor status in payer portals while ensuring accurate documentation and patient-focused service.

Ideal candidates have at least one year in medical insurance verification or prior authorization, with healthcare setting experience preferred.

Qualifications

• One year of related experience with medical insurance plans and/or Medicare benefits verification.
• One-year medical clinic, urgent care, or hospital care setting experience preferred.
• Prior Authorization experience preferred.

Responsibilities

• Review and completion of prior authorizations to ensure timeliness of appointments, testing, procedures, and claims filing.
• Obtain clinical information such as medical history, diagnosis, and relevant lab reports to complete prior authorizations.
• Follow criteria for services requiring prior authorizations and submit requests in a timely manner.
• Track status of prior authorizations via payor portals.
• Review denied claims for clinical accuracy and resubmit with corrections.
• Communicate with insurance companies to pre-certify/authorize/amend services.
• Recommend new approaches and procedures to improve department efficiency.
• Coordinate resolution between appropriate parties and ensure documentation in billing systems.
• Research Patient Visit History to ensure payor payment window compliance and guide patient payments.
• Perform other related job functions and uphold Code of Conduct and Values.

Education

High School Diploma or GED

Job description

HCA Healthcare is hiring an Authorization Coordinator to work from home, supporting timely pre-certifications and authorizations across payors. You will collect clinical data, apply authorization criteria, and monitor status in payer portals while ensuring accurate documentation and patient-focused service.

Ideal candidates have at least one year in medical insurance verification or prior authorization, with healthcare setting experience preferred.