Authorization Coordinator

Stanford Medicine Children's Health

. Provide day-to-day financial clearance of scheduled services assigned to the Authorization department work queues .

Posted 11/6/2026full-timeRemote • California • United StatesJuniorMid-Level💰 $34 - $43 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in financial clearance processes, authorization management, and patient advocacy while ensuring compliance with hospital policies and regulatory standards. Proficient in analyzing operational issues and collaborating effectively with healthcare providers and staff.

Highest-signal resume keywords

Financial Clearance ManagementAuthorization ProcessingMedical Terminology KnowledgeInsurance Issue ResolutionCustomer Service Excellence

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Authorization ManagementOperational AnalysisClaims ProcessingReferral CoordinationDocumentation TrackingProblem ResolutionPayer CommunicationPeer-to-Peer RequestsMedical Justification ResearchPatient Account Management

Soft Skills

Effective CommunicationCollaborationAdvocacyInterpersonal SkillsProblem-Solving

Tools & Technologies

Computer SystemsAuthorization Software

Industry Keywords

MedicareMedi-CalWorkers CompManaged CareChildren's Health ProgramsJoint Commission ComplianceNational Patient Safety Goals

About the role

Key responsibilities & impact

Provide day-to-day financial clearance of scheduled services assigned to the Authorization department work queues
Serve as a resource for departments on complex referral and authorization issues and problem resolution
Advise on authorization-related questions
Provide high-quality customer service according to Hospital PCARES practices and department regulations, policies and procedures
Act as a patient and family advocate by obtaining necessary provider information and fulfilling payer referral and authorization requirements
Collaborate with providers and service-site staff to obtain referrals and authorizations
Track and document patient accounts, authorization status, follow-up actions and payer issues
Help prioritize clinically urgent cases and secure authorizations in advance to minimize financial risk
Process and follow up on denied authorizations, peer-to-peer requests and further medical justification requirements
Research, review and resubmit authorizations as needed
Clear authorization claims edits holding claims according to department metrics and standards
Investigate, resolve and document insurance issues and contact relevant stakeholders
Coordinate with contracting to obtain letters of agreement for patients with non-contracted coverage
Inform the Authorization Assistant Manager of potential deferrals or denials of elective/non-emergent services
Communicate with access nurses and clinicians for triage and insurance issue resolution

Requirements

What you’ll need

High school diploma or GED equivalent
Two years of directly-related experience
Ability to analyze operational and procedural problems and develop, recommend and evaluate proposed solutions
Ability to speak and write effectively at a level appropriate for the job
Ability to work well with individuals at all levels of the organization
Knowledge of computer systems and software used in the functional area
Knowledge of Medical Terminology
Knowledge of Medicare, Medi-Cal, Workers Comp, Managed Care (HMO, PPO, POS, etc.), Children's Health Programs (CCS, GHPP, Healthy Families, etc.)
No licensure or certification required
Must comply with Joint Commission requirements, hospital policies and procedures, safety and quality programs, National Patient Safety Goals, licensure and health screenings

Benefits

Comp & perks

Benefits eligible
Full-time employee position
Continuing education
State-of-the-art facilities
Reasonable accommodations for individuals with disabilities
Equal opportunity and non-discrimination
Employee referral amount: $375