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Who We Are
As the largest and most comprehensive orthopaedic team in the state, we bring together the medical expertise of leading orthopaedic and musculoskeletal surgeons, specialists, and research pioneers. Every provider in our network shares a deep commitment to leadership in education, innovation, and research, as well as a dedicated focus on prioritizing patient care across the continuum of treatment.
Why Join Us?
Interested in orthopaedics? Discover why it’s worth pursuing with us. Our career opportunities offer competitive salaries, outstanding benefits, and a platform to pursue your passion. As Michigan’s largest and most comprehensive orthopaedic team, we are actively seeking skilled and enthusiastic individuals to join us today.
Position Summary
The Authorization Coordinator plays an essential role in supporting timely patient care by obtaining and managing insurance authorizations for a variety of services, including advanced imaging, pain management procedures, Durable Medical Equipment (DME), Physical Therapy (PT), Occupational Therapy (OT), medications, and other assigned services.
This role works closely with insurance companies, physicians, clinical teams, scheduling staff, patients, and outside facilities to ensure authorization requirements are completed accurately and efficiently. Success in this role requires strong attention to detail, organization, communication, problem-solving skills, and the ability to manage multiple priorities in a fast-paced healthcare environment.
Key Responsibilities
Authorization Submission & Management
- Obtain and submit prior authorizations for advanced imaging, pain management procedures, DME, PT/OT, medications, and other assigned services.
- Review physician orders, clinical documentation, and payer requirements to ensure authorization requests are complete and accurate.
- Monitor pending authorization requests and complete timely follow-up to prevent unnecessary delays in patient care.
Denials, Appeals & Payer Requirements
- Understand and follow payer-specific authorization requirements and organizational protocols.
- Coordinate next steps for denials, appeals, peer-to-peer reviews, and requests for additional clinical information.
- Maintain current knowledge of insurance guidelines and changes in authorization requirements.
Documentation & Accuracy
- Maintain accurate and thorough documentation of authorization activity, including submissions, status updates, authorization numbers, effective dates, payer communications, and reference information.
- Verify authorization details are accurate and appropriate for the requested service, provider, facility, and date of service.
Communication & Collaboration
- Communicate authorization approvals, denials, pending requirements, and other updates to physicians, clinical staff, patients, scheduling teams, and rendering facilities as appropriate.
- Collaborate with multiple departments to obtain missing orders, clinical documentation, or other information needed to complete authorization requests.
- Respond promptly and professionally to authorization-related questions and requests while helping resolve issues that could delay patient care.
Prioritization & Department Support
- Prioritize authorization requests based on urgency, date of service, payer requirements, and departmental protocols, including appropriate handling of urgent and STAT requests.
- Maintain patient confidentiality and comply with HIPAA, organizational policies, and applicable regulations.
- Participate in departmental training, cross-training, and process improvement initiatives and perform additional duties that support departmental operations.
What Success Looks Like
Successful Authorization Coordinators:
- Complete authorization requests accurately and within appropriate timeframes.
- Consistently follow up on pending cases and take ownership of requests through resolution.
- Maintain complete, clear, and accurate documentation of authorization activity.
- Proactively identify missing information or potential authorization barriers and work with the appropriate teams to resolve them.
- Communicate effectively with insurance companies, patients, providers, facilities, and internal departments.
- Effectively prioritize workload based on urgency and patient needs.
- Demonstrate professionalism, accountability, attention to detail, and strong problem-solving skills.
- Contribute to a collaborative team environment focused on preventing delays and supporting quality patient care.
Qualifications
Required
- High school diploma or GED.
- Minimum one (1) year of experience with healthcare related authorizations.
- Strong communication, organizational, and computer skills.
Preferred
- One (1) year of experience in submitting advanced imaging insurance authorizations.
Michigan Orthopaedic Surgeons participates in E-Verify to confirm the identity and employment eligibility of newly hired employees.
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