Prior Authorization Coordinator

Remote Raven is hiring a full-time Prior Authorization Coordinator to support a multi-location dermatology and skin cancer surgical group in Arizona. The practice provides medical dermatology, skin cancer detection and surgical treatment, aesthetics, and allergy services across several Arizona locations, and it performs a steady volume of scheduled surgical procedures.

The Prior Authorization Coordinator is responsible for ensuring that every upcoming surgical procedure carries a valid, correctly matched insurance authorization before the patient arrives. That means determining what each plan requires for the specific CPT codes planned, submitting the request through the channel that plan uses, tracking it to a decision, appealing it when it is denied, documenting it so the care team is informed in advance, and staying reachable in Microsoft Teams while the schedule moves around you.

This role suits someone who has already worked a US prior authorization desk and knows that the difficulty is not the submission. The difficulty is closing every case before its date of service, on a schedule that changes, with plans that each behave differently. You will be measured on whether authorizations are in place and correct on the morning of surgery.

Key Responsibilities

Coverage Review & Determination

• Review patient insurance policies to determine the specific prior authorization requirements that apply, based on the CPT codes planned for each upcoming surgical procedure.
• Identify the plan and administrator that actually governs each case rather than relying on the payer name on the front of the card, so requirements are checked against the right rules.
• Confirm eligibility and coverage for the scheduled date of service before a request is built.

Submission

• Initiate prior authorization requests through payer provider portals, by phone, or by fax submission, using whichever channel the plan requires.
• Assemble the clinical documentation each request needs, including the diagnosis, the planned procedure, and the supporting notes or pathology the plan expects to see.

Tracking & Follow-Through

• Track every submitted request through to a decision, working by the date of the patient’s appointment rather than by the date the request was sent.
• Follow up on pended requests, respond promptly when a plan asks for additional clinical information, and escalate any case at risk of missing its surgical date.
• Ensure approvals are obtained and are properly attached and linked to the patient’s scheduled appointment.

Appeals & Denials

• Prepare and submit appeals when authorization requests are denied or require reconsideration, working from the plan’s stated denial reason rather than a generic template.
• Coordinate peer-to-peer reviews and expedited reviews where the plan offers them and the surgical date requires it.

Documentation & Care-Team Communication

• Accurately document all prior authorization activity in patient charts so the care team is fully informed before the patient’s appointment.
• Record authorization numbers, effective and expiry dates, approved codes and units, and the status of anything still outstanding, so no colleague has to interrupt you to find out where a case stands.

Patient Communication

• Communicate with patients when necessary to explain the prior authorization process, set expectations on timing, or request additional information the plan requires.

Real-Time Coordination

• Monitor Microsoft Teams throughout the shift for questions, clarifications, and appointment updates that may affect prior authorization status, and respond in real time.
• Work fluidly across several computer-based information systems at once, keeping the surgical schedule, the payer portals, and the patient chart in agreement with each other.

Requirements

• At least one year of hands-on US healthcare prior authorization experience in a provider setting: a practice, clinic, hospital, or a medical billing or revenue cycle company serving US providers.
• Direct experience submitting prior authorization requests through payer provider portals, plus comfort using phone and fax where a plan requires it.
• Working familiarity with CPT procedure codes and ICD-10 diagnosis codes, enough to read a provider’s planned procedure and check it against a plan’s requirements.
• Experience preparing or submitting appeals on denied authorizations.
• Clear spoken and written English that holds up both on a call with a US insurance representative and in a conversation with an anxious patient.
• Strong attention to detail and organizational skills, including a tracking method you built and maintain yourself.
• Strong problem analysis and resolution skills.
• Ability to multitask effectively across multiple computer-based information systems.
• Capacity to work independently and remain productive in a self-directed environment with limited day-to-day supervision.
• A reliable computer, a stable primary internet connection with a backup option, a quiet space for calls, and a headset.

Preferred Qualifications

• Prior authorization experience in dermatology, dermatologic surgery, plastic surgery, or another procedure-heavy specialty.
• Familiarity with surgical dermatology workflows such as Mohs micrographic surgery, excisions, and repairs.
• Experience across a mixed payer base including commercial plans, Medicare Advantage, Medicaid managed care, and marketplace plans.
• Experience with multi-payer provider portals such as Availity, alongside plan-specific provider portals.
• Experience in a multi-location or multi-provider practice, where the correct provider and location must be carried onto the authorization.
• Proficiency with Microsoft Teams, Outlook, and Excel.
• Experience working directly for a US-based employer or client.

Tools & Software

• Microsoft Teams — the primary real-time channel for the care team
• Microsoft Outlook
• Microsoft Excel
• Payer provider portals, both multi-payer and plan-specific
• The practice’s electronic medical record and surgical scheduling system
• Hubstaff (time tracking)

What Makes You a Great Fit

• You work the list by what is closest to happening to a patient, not by what arrived most recently.
• You would rather raise a problem three days early and be told it was nothing than raise it on the morning of surgery.
• You treat a verbal "that should be fine" from a call centre as information, not as an approval.
• You write chart notes complete enough that a colleague can answer a question without calling you.
• You notice when an approval no longer matches the procedure that is about to be performed.
• You can stay warm and clear with a patient who is worried about their surgery and frustrated with their insurer.
• You are steady on a schedule that runs against your local clock, and you plan your life around it rather than hoping it will change.

Working Hours

• Monday to Friday, 8:30 AM to 5:00 PM US Mountain Standard Time (Arizona).
• Arizona does not observe daylight saving time, so this window stays the same all year and never shifts with US clock changes.
• Full overlap with clinic hours is required: payer phone lines, the clinical team, and the surgical schedule are all live during that window.

Benefits

What We Offer

• Up to $6/hour
• 100% remote work
• Full-time role

We hire for the long haul, so a steady track record of staying and growing always moves you up our list.

To apply:

Ensure your LinkedIn profile and resume are up-to-date and comprehensive (submit a comprehensive resume in English, PDF format), and complete the assessment in this link: []

A quick note on how we will reach you: our recruitment team communicates primarily through Telegram, using the mobile number on your application and resume. Please make sure that number is active and registered on Telegram, since this is where screening and interview scheduling happen. If it is not registered yet, you can set it up right after you apply — it takes only a few minutes and keeps your application moving without delay.

By applying, you consent to being contacted via the contact information provided in your application for recruitment purposes only.

Because of the volume of applications we receive, we're only able to follow up directly with candidates whose experience closely matches this role. If you don't hear from us within 10 days, please know we genuinely appreciate your interest—and we'd welcome your application to future openings that may be a stronger fit. Thank you for considering Remote Raven, and all the best in your search.

A note on scheduling: initial interviews run in US Mountain Standard Time (MST) within a 3:00 AM – 1:00 PM MST window. We know that takes flexibility around the time difference, and we genuinely appreciate it.