Remote Authorization & Payer Support Specialist

Cedars-Sinai; Colorado Springs (CO); Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Paid time off

403(b)

Job summary

Cedars-Sinai in Colorado Springs seeks an experienced authorization professional to support timely utilization review and payer submissions. You will assemble clinical packets, review records for required documentation, and track determinations across payer systems.

Responsibilities include managing the authorization lifecycle, following up with payers, and escalating urgent issues to prevent denials. Strong communication with internal teams is essential.

Qualifications

• High school diploma or GED required. Associate's degree or college diploma in business or health preferred.
• Minimum of 2 years of experience in hospital authorization management or payer communication processes.
• Experience independently managing authorization workflows preferred.
• Minimum of 2 years of acute care experience preferred.

Responsibilities

• Maintain an assigned portfolio of cases with UR Nurses for timely utilization review.
• Prepare and assemble clinical review packets and documentation for payer submission.
• Review records to confirm required documentation is present before submission.
• Track submission confirmations and follow up on payer determinations.
• Manage the authorization lifecycle for assigned cases, including data entry and timelines.
• Monitor payer portals and contact payers to obtain authorization updates.
• Prioritize cases by deadlines and regulatory timeframes.
• Escalate urgent authorization issues to avoid denials or lapses.
• Coordinate peer-to-peer scheduling and maintain related docs.
• Document payer determinations in EPIC/CS-Link per standards.
• Identify patterns in workflows and report trends to UM leadership.

Skills

Payer communication

Utilization review

Revenue cycle

Case management

Education

High school diploma

Associate's degree (preferred)

Tools

EPIC/CS-Link

Job description

Cedars-Sinai in Colorado Springs seeks an experienced authorization professional to support timely utilization review and payer submissions. You will assemble clinical packets, review records for required documentation, and track determinations across payer systems.

Responsibilities include managing the authorization lifecycle, following up with payers, and escalating urgent issues to prevent denials. Strong communication with internal teams is essential.