Remote Authorization Specialist – Healthcare Revenue Cycle

Cedars-Sinai; Austin (TX); Remote; USD 65.000 - 85.000; Vollzeit

Zusammenfassung

Cedars-Sinai in Austin, TX, is seeking an Authorization Coordinator to maintain an assigned case portfolio in collaboration with UR Nurses. You will prepare clinical review packets, verify documentation, and manage the authorization lifecycle to support timely payer determinations.

Expe rience in hospital authorization and utilization review is preferred. The role emphasizes accurate EPIC/CS-Link documentation, proactive communication with payers, and escalation of urgent issues to prevent

Qualifikationen

• High school diploma or GED required.
• Associate's degree or college diploma in business or health-related fields preferred.
• Minimum 2 years of experience in hospital authorization management, utilization review support, or payer communication processes.

Aufgaben

• Maintain an assigned portfolio of cases in partnership with UR Nurses to support timely utilization review activities.
• Prepare and assemble clinical review packets and supporting documentation for payer submission.
• Review records to confirm required documentation elements are present prior to submission and elevate gaps to the assigned UR Nurse.
• Track submission confirmations and ensure timely follow up on pending payer determinations.
• Manage the authorization lifecycle for assigned cases, including entry, tracking, follow up, documentation of determinations, and monitoring of payer response timelines.
• Monitor payer portals and contact payers directly, as needed, to obtain authorization updates and resolve status discrepancies.
• Independently prioritize cases based on submission deadlines, authorization expiration risk, and regulatory timeframes.
• Escalate urgent authorization issues, delays, or barriers that may result in avoidable denials or authorization lapses.
• Coordinate peer to peer scheduling logistics and maintain related documentation.
• Document and communicate payer determinations, including approvals, partial approvals, and denials, in EPIC/CS-Link in accordance with departmental and regulatory standards.
• Identify patterns or systemic authorization workflow issues and communicate trends to UM leadership.
• Document and communicate payer determinations, including approvals, partial approvals, and denials.
• Ensure all required documentation is accurately entered into EPIC/CS-Link in accordance with departmental and regulatory standards.
• Communicate effectively with internal and external partners to ensure patient and authorization information is current and complete.

Ausbildung

High school diploma or GED

Associate's degree preferred

Jobbeschreibung

Cedars-Sinai in Austin, TX, is seeking an Authorization Coordinator to maintain an assigned case portfolio in collaboration with UR Nurses. You will prepare clinical review packets, verify documentation, and manage the authorization lifecycle to support timely payer determinations.

Expe rience in hospital authorization and utilization review is preferred. The role emphasizes accurate EPIC/CS-Link documentation, proactive communication with payers, and escalation of urgent issues to prevent