{"id":1756689,"url":"https://alion.io/job/chnct-prior-authorization-coordinator-2","title":"Prior Authorization Coordinator","company":{"id":3876296,"name":"Chnct","domain":"chnct.org","url":"https://alion.io/company/chnct","size_band":null,"is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"ADP","truth_index":null},"role":"Administrative","role_family":"Administrative","seniority":"middle","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"inferred_payroll_markers","remote_working_hours":null,"hiring_geo_confidence":"inferred","locations":[],"countries":[],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":51075,"max":68100,"currency":"USD","period":"year","gross":null,"usd_annual":68100},"salary_estimate":null,"experience_years_min":3,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[],"status":"live","first_seen_at":"2026-10-02T15:19:00Z","employer_posted_date":"2026-10-02","last_verified_at":"2026-10-26T05:26:36Z","board_verified":true,"closed_at":null,"days_open":23,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":23},"description":"Community Health Network of Connecticut, Inc. (CHNCT) is currently seeking a Prior Authorization Coordinator to join our team.\nPrimary Responsibilities:\nWorks collaboratively with Health Services’ staff in conducting medical necessity review\nactivities for Community Health Network members. \nApproves or denies services based on benefit package and medical necessity criteria.\nTasks Performed:\nResponds to telephonic and written requests by CHNCT providers for authorization and benefit coverage for CHNCT members. \nConducts medical necessity review of requests for DME, outpatient therapies and prior authorizations for inpatient and outpatient procedures.\nIdentifies need for coordination of benefits and identifies third party liability as appropriate.\nUtilizes the InterQual and or Medicaid criteria to make decisions. \nSelects, formats, proofreads and prints appropriate member and provider denial letters prior to mailing.\nRefers cases to CHNCT Medical Reviewer when clinical information does not support medical necessity. \nAssists in education of primary care providers, specialists and ancillary providers on CHNCT policies and procedures. \nPerforms other duties as assigned.\nEssential Functions:\nMaintains knowledge of covered benefits for Medicaid programs. \nShares information as necessary with appropriate clinical staff. \nIdentifies and refers cases appropriate for Intensive Care Management evaluation. \nIdentifies authorization issues and brings those requiring attention to the Manager for resolution.\nReviews requests for non-par services and approves or denies based on guidelines/policies. \nReviews requests for services not included in member’s benefit package.\nDesired Education: Two years post-secondary schooling\nDesired Degree: Associate's degree\nDesired Major: Licensed practical nursing\nDesired Job Experience: 3 to 5 years’ related experience\nCertifications Required: Active Licensed Practical Nurse License\nCHNCT Offers Great Benefits:\nMedical, dental and vision coverage options\nFlexible spending and health savings accounts\nGroup term life insurance\nA 401(k) plan with company-match and immediate vesting\nVoluntary accidental injury coverage\nTuition reimbursement and continuing education opportunities\nA generous paid-leave bank and company holidays\nWellness program\nWe are dedicated to having a workplace where everyone feels valued, respected, and empowered to succeed. We embrace a wide range of perspectives and backgrounds, ensuring fair treatment and opportunities for all employees. We value our team’s rich array of experiences and viewpoints, which contribute to our innovative and collaborative environment. \nWe are committed to providing an inclusive and accessible interview process. If you require a reasonable accommodation for your interview due to a disability. Please contact us in advance if you need an accommodation.","description_format":"text","description_chars":2868,"description_truncated":false,"requirements":{"experience_years_min":3,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"associate","optional":true},"security_clearance":false,"languages":[]},"benefits":["Life insurance"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":[],"lifecycle":[{"event":"open","at":"2026-10-03T11:00:54Z"}],"visa":[],"liveness":{"score":58,"band":"ok","label":"Likely open","p_open":1,"p_active":0.769,"p_room":0.75,"age_days":23,"expected_fill_days":28,"reasons":["conf:0","win:late"],"computed_at":"2026-10-26T05:57:25Z"},"pay":{"stated_usd_annual":68100,"is_top_pay":true},"html_url":"https://alion.io/job/chnct-prior-authorization-coordinator-2","json_url":"https://alion.io/job/chnct-prior-authorization-coordinator-2.json","meta":{"generated_at":"2026-10-26T08:47:42Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":11675,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-27T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":3876296},"rest":"https://alion.io/mcp/rest/get_company?id=3876296"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fchnct-prior-authorization-coordinator-2"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fchnct-prior-authorization-coordinator-2"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fchnct-prior-authorization-coordinator-2"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/chnct-prior-authorization-coordinator-2\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fchnct-prior-authorization-coordinator-2"}]}