{"id":1445035,"url":"https://alion.io/job/pediatric-chaplains-network-authorization-coordinator","title":"Authorization Coordinator","company":{"id":1875671,"name":"Pediatric Chaplains Network","domain":"pediatricchaplains.org","url":"https://alion.io/company/pediatricchaplains","size_band":"1001-5000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"B","score":77,"open_postings":11,"ghost_share":0,"stale_share":0.909,"repost_share":0,"time_to_fill_p50_days":32,"computed_at":"2026-10-25T05:49:26Z"}},"role":"Administrative","role_family":"Administrative","seniority":null,"employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Corpus Christi, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":{"min_usd":33000,"max_usd":73000,"period":"year","method":"role_country_seniority_unknown","sample_n":10823},"experience_years_min":null,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false},{"name":"Microsoft Office","optional":false},{"name":"Outlook","optional":false}],"status":"live","first_seen_at":"2026-09-21T00:00:00Z","employer_posted_date":"2026-09-21","last_verified_at":"2026-10-22T15:42:40Z","board_verified":false,"closed_at":null,"days_open":34,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":34},"description":"Where compassion meets innovation and technology and our employees are family.\nThank you for your interest in joining our team! Please review the job information below.\nGENERAL PURPOSE OF JOB:\nReports to the Central Patient Access Supervisor and serves as a primary point of contact for high-volume inbound calls and referral/authorization requests from physician offices and internal departments. Processes internal and\nexternal referrals by obtaining and submitting medical records, verifying eligibility, securing benefit coverage determinations, guiding network steerage, and resolving referral issues. Work is primarily telephonic, computer-based, and office-based, and directly supports timely, appropriate patient care and health promotion by ensuring accurate, payer-compliant authorizations.\nESSENTIAL DUTIES AND RESPONSIBILITIES:\nTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required.\nReceives and documents, telephonic, and electronic requests for referrals from Primary Care Physicians, Specialists and Ancillary providers\nContacts review organizations and insurance companies to obtain prior approval requirements and submit appropriate documentation.\nVerifies member eligibility and basic benefit coverage levels including obtaining information on coordination of benefits and third-party liability as appropriate.\nMaintains a current working knowledge of all Health Plan carrier requirements for referral request authorizations and approval path requirements. (Pre-Determinations and Peer to Peers)\nInvestigates and obtains from providers, missing medical information required for referral submission.\nUtilizes computer resources to determine provider networks.\nPer referral guidelines evaluates each referral request to ensure the referral request including codes, place of service, service type, provider and all required medical information is available for submission to insurance carriers.\nApplies knowledge and application of ICD-9 and CPT coding, as well as medical terminology for appropriate communication with physicians and providers\nPerforms data entry/processing of referral requests through the EPIC system, and edits referral notes with appropriate information as outlined per department procedures.\nAdheres to hospital policies and procedures.\nDemonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.\nAdheres and comply with customer service standards and dress code as set forth by the hospital and the department.\nUnderstand and apply payer rules to include commercial, Medicaid/CHIP, Medicare; OON vs INN rules; pre-auth vs pre-cert vs notification.\nCPT/HCPCS, ICD-10-CM, modifiers (incl. therapy, radiology, surgical bundles), NCD/LCD & payer medical-necessity criteria.\nSite-of-service & modality requirements (OP hospital, ASC, free-standing, telehealth).\nCoordination points: clinic workflows, surgery scheduling, imaging, pharmacy/infusion, DME, rehab, SLP/PT/OT.\nPrivacy & compliance: HIPAA, minimum necessary, consent and minor/guardian nuances.\nEHR/PM and clearinghouse fundamentals; payer portals (Availity, UHC, BCBS portals, TMHP, etc.).\nOther duties as assigned\nFunctions as a resource to physician/provider offices regarding steerage, referral process questions and education on Health Plan authorization submission requirements.\nProvides source of referral and prior approval requests with timely notification of approval or denial decisions through designated communication routes.\nResources Senior Authorization Coordinator or Supervisor/Manager for review of complex referral requests and issues\nWorks with Physician offices to provide ongoing education regarding referral process and requirements.\nProvides input to Team Lead and Supervisor/Manager regarding improvements to operating practices\nAssists with orientation and training of new staff\nCustomer Service Duties\nAnswers the department telephone immediately or within three rings utilizing courtesy and patience\nListens to customer needs and takes appropriate action as indicated\nRespond to urgent emails and voicemails promptly\nGather patient demographic and financial information in a kind and courteous manner\nDocument telephone encounters.\nConduct warm transfers as needed\nRespond to urgent emails and voicemails promptly, and respond to non-urgent emails and voicemails at the end of the day\nPlace outbound calls to referring providers or guardians (for self-referrals) to obtain missing and validate existing information\nFacilitate referral intake\nComplete any additional ancillary tasks\nPatient Accounting Duties\nAccurately create patient encounter in patient accounting systems utilizing the appropriate patient search criteria and interview method\nVerify patient’s insurance benefit and document findings, this process should be completed in the appropriate timeframe for the service being provided\nRefer cases for financial screening as indicated\nComplete all authorization procurement work functions as indicated\nRead orders, match CPT/DX, validate medical necessity, spot missing documentation.\nDocumentation: clear, concise auth notes; attach evidence (guidelines, MD notes); version control of templates.\nEHR work queues, tasking, payer portals, fax/e-fax tools; Excel/Sheets for trackers; Outlook/Teams etiquette.\nCommunication: concise emails to clinics and payers; parent/guardian education on auth status and expectations.\nProblem-solving: navigate ambiguous policies, escalate edge cases, craft payer-specific justifications.\nTime management: handle high-volume queues, SLAs, and stat cases without losing accuracy.\nData use: read denials reports, find root causes, update templates to prevent repeats.\nAccurately collect and enter patient demographics into patient accounting systems as indicated\nPopulate referral data elements into Epic Referral Record as indicated\nComplete documentation in Epic according to Driscoll Health System and department documentation guidelines\nRevenue cycle basics: denials taxonomy, timely filing, retro-auth risk, ABN/financial clearance.\nQuality Assurance Duties\nReview schedule/pre-registrations/registrations to identify potential duplicate medical record numbers.\nUpdate data discrepancies in Epic.\nIdentify patients with multiple same day visits to match demographic and insurance data for each pre-registration.\nReview patient demographic and financial data to ensure accuracy\nValidate verification and documentation of insurance eligibility and coverage for anticipated procedures.\nValidate insurance authorizations was obtained from referring physicians and payors when necessary/appropriate.\nReviews pre-registration list for cancellations and notify department as indicated.\nIdentify patients that are missing any pre-registration items\nCheck for referral minimum data set elements\nEDUCATION AND/OR EXPERIENCE:\nHS diploma/GED required; 2+ years in patient access, scheduling, billing, or utilization review; or equivalent combination of education and experience.\nWorking experience of Epic system preferred.\nWorking knowledge of CPT/ICD-10 and at least two major payer portals.\nProficient computer navigation skills, with basic/advanced Microsoft Office/Outlook and intra/internet experience.\nMedical Terminology Knowledge required.\nExperience in a fast pace telephonic, production-oriented and metric driven work environment.\nExperience working with physicians and clinical staff in a medical or clinical setting.\nSpecialty experience (cardiology/cath, infusion/high-cost meds, imaging/surgery).\nPrior denials/appeals or financial clearance experience.","description_format":"text","description_chars":8070,"description_truncated":false,"requirements":{"experience_years_min":null,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"high_school","optional":false},"security_clearance":false,"languages":[]},"benefits":[],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":["Health Care","Pediatric Care"],"lifecycle":[{"event":"open","at":"2026-09-29T06:20:25Z"}],"visa":[],"liveness":{"score":22,"band":"cold","label":"Long shot","p_open":0.9,"p_active":0.436,"p_room":0.55,"age_days":34,"expected_fill_days":32,"reasons":["conf:62","stale_co","win:tail"],"computed_at":"2026-10-25T05:49:26Z"},"pay":null,"html_url":"https://alion.io/job/pediatric-chaplains-network-authorization-coordinator","json_url":"https://alion.io/job/pediatric-chaplains-network-authorization-coordinator.json","meta":{"generated_at":"2026-10-25T08:14:33Z","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":11734,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-26T00:00:00Z"}},"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":1875671},"rest":"https://alion.io/mcp/rest/get_company?id=1875671"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fpediatric-chaplains-network-authorization-coordinator"},{"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%2Fpediatric-chaplains-network-authorization-coordinator"},{"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%2Fpediatric-chaplains-network-authorization-coordinator"},{"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/pediatric-chaplains-network-authorization-coordinator\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fpediatric-chaplains-network-authorization-coordinator"}]}