Authorization Coordinator - Orthopedics
The University of California, San Diego
About this position
Position Description
The Authorization Coordinator is responsible for obtaining and managing prior authorizations for outpatient procedures, surgeries, injections, and diagnostic services. This role reviews provider orders and clinical documentation to ensure payer requirements are met and communicates directly with insurance payers to verify coverage, authorization criteria, and medical necessity. The Authorization Coordinator tracks authorization status, manages work queues, and resolves delays or denials to support timely access to care. In addition, this role coordinates and schedules patient appointments, procedures, once authorization is approved, collaborating closely with providers, clinic staff, and surgical scheduling teams. The position also communicates authorization and scheduling updates to patients and ensures all authorization and scheduling activities are accurately documented in the electronic health record.
Qualifications
Three (3) years of directly related experience in a large complex healthcare or Orthopedics clinic setting; or an equivalent combination of education and experience. Three (3) years of recent Home Health and Durable Medical Equipment (DME) experience. In depth knowledge of hospital registration and insurance authorizations, including ICD-9, CPT, and HCPCS Codes. Prior experience with EPIC, IDX , PCIS, and MS Office (Word, Excel, Outlook, PowerPoint), with demonstrated skill working between multiple systems during calls. Possess excellent customer service skills. Familiar with EPIC Cadence and WQs preferred.