Supporting the Medical Management team, the full-time Prior Authorization Coordinator will investigate and process prior authorization requests while working from home. Key responsibilities: Review and research referral and authorization requests, processing them according to guidelines Provide education to members and providers regarding the prior authorization process Ensure timely processing of documentation and maintain compliance with HIPAA and other regulatory guidelines Required qualifications: High school education or equivalent 1-2 years of experience in a medical office and/or insurance environment Strong understanding of medical terminology, coding, and health plan benefits Proficiency in Microsoft Office applications and typing skills (minimum 35 wpm) Ability to analyze claims and authorizations for accuracy and compliance