Senior Coordinator, Prior Authorization
Not Disclosed•Full-TimeRemote
location_onGranchina, Calle Guayama, 00917, United States
About Customer Service Operations
Customer Service Operations at Cardinal Health serves as a critical liaison between patients, providers, and payers. Our mission is to establish, maintain, and enhance customer business by managing complex contract administration, order processing, and problem resolution. Specifically, our team provides outsourced services for medical billing and reimbursement, acting as the primary point of contact for research and dispute resolution to ensure seamless care delivery.
About the Role
The Senior Coordinator, Prior Authorization is a pivotal role within our team, dedicated to securing timely payer approvals for durable medical equipment (DME). You will be the bridge that ensures patients receive essential supplies, such as diabetes devices, ostomy, urological, and wound care products, without interruption.
In this position, you will navigate a dynamic landscape of payer portals, fax systems, and phone communications to document and track approvals. Your day will involve proactively managing expiring authorizations to prevent order delays, adhering to strict quality and HIPAA compliance standards, and collaborating with provider offices to resolve complex issues. This role is designed for a self-motivated professional who thrives in a queue-based environment and takes ownership of their workflow to meet daily productivity targets.
Hiring Process
Candidates interested in this opportunity are encouraged to submit their applications as soon as possible, as the application window is anticipated to close on May 5, 2026. Please note that the hourly range listed is an estimate and pay is determined by factors including geographical location, education, experience, skills, and internal pay equity.
Our Culture and Commitment to Diversity
Cardinal Health supports an inclusive workplace that values diversity of thought, experience, and background. We celebrate the power of our differences to create better solutions for our customers, ensuring that every employee can be their authentic self each day. We actively encourage applications from candidates who are back-to-work, people with disabilities, those without a college degree, and Veterans.
Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status, or any other status protected by federal, state, or local law.
Work location
Work model: Remote
Granchina, Calle Guayama, 00917, United States
Key Responsibilities
- check_circleReview assigned accounts to determine prior authorization requirements by payer and product category
- check_circlePrepare and submit complete prior auth packets via payer portals, third-party platforms, or fax
- check_circleConduct phone-based follow-ups with payers and provider offices to confirm receipt and obtain approvals
- check_circleLog approvals accurately and correct rejected decisions by addressing missing documentation
- check_circleMonitor upcoming prior auth expirations and initiate re-authorization early to prevent shipment delays
- check_circlePrioritize work based on aging, SLA, and payer requirements to meet daily throughput goals
- check_circleCapture all actions and decisions in systems with complete, audit-ready notes
- check_circleEnsure secure handling of PHI and maintain full compliance with HIPAA and regulatory requirements
Requirements
- verifiedHigh School diploma, GED or equivalent work experience
- verified3-6 years of experience in healthcare payer-facing work
- verifiedWorking knowledge of HIPAA and secure handling of PHI
- verifiedExperience with diabetes devices and familiarity with ostomy, urological, and wound care product categories
- verifiedKnowledge of payer criteria for DME prior authorization
- verifiedFamiliarity with payer portals and third-party platforms
- verifiedExposure to ICD-10/HCPCS coding and basic authorization/claims terminology
Nice to Have
High School diploma, GED or equivalent work experience. 3-6 years of experience in healthcare payer-facing work such as prior authorization, insurance verification, medical documentation, revenue cycle, or claims. Proven ability to meet daily productivity targets and quality standards in a queue-based environment. Strong phone skills and professional communication with payers and provider offices; comfortable with sustained phone work. High attention to detail and accuracy when compiling documentation. Self-motivated with strong time management; able to pace independently without inbound-call cadence. Customer-centric mindset with a sense of urgency; capable of multitasking. Working knowledge of HIPAA and secure handling of PHI. Experience with diabetes devices (CGMs, insulin pumps), and familiarity with ostomy, urological, and wound care product categories. Knowledge of payer criteria for DME prior authorization, including common documentation requirements and medical necessity standards. Familiarity with payer portals and third-party platforms; experience with Grid or other work allocation tools. Exposure to ICD-10/HCPCS coding and basic authorization/claims terminology.
Benefits & Perks
check_circleMedical, dental, and vision coveragecheck_circlePaid time off plancheck_circleHealth savings account (HSA)check_circle401k savings planAccess to wages before pay day with myFlexPay
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Skills, education and keywords
Skills: Prior Authorization, Insurance Verification, Medical Documentation, Revenue Cycle, Claims, Hipaa, Icd-10, HCPCS.
Education: High School diploma, GED or equivalent work experience, preferred.
Frequently asked questions about Senior Coordinator, Prior Authorization at Cardinal Health
What does a Senior Coordinator, Prior Authorization at Cardinal Health do?expand_more
Day-to-day, the Senior Coordinator, Prior Authorization at Cardinal Health will review assigned accounts to determine prior authorization requirements by payer and product category; prepare and submit complete prior auth packets via payer portals, third-party platforms, or fax; conduct phone-based follow-ups with payers and provider offices to confirm receipt and obtain approvals; and log approvals accurately and correct rejected decisions by addressing missing documentation.
What are the requirements for this Senior Coordinator, Prior Authorization role?expand_more
To qualify for the Senior Coordinator, Prior Authorization at Cardinal Health position, applicants should have: High School diploma, GED or equivalent work experience; 3-6 years of experience in healthcare payer-facing work; Working knowledge of HIPAA and secure handling of PHI; Experience with diabetes devices and familiarity with ostomy, urological, and wound care product categories; Knowledge of payer criteria for DME prior authorization; and Familiarity with payer portals and third-party platforms.
Where is the Senior Coordinator, Prior Authorization role at Cardinal Health located?expand_more
Senior Coordinator, Prior Authorization at Cardinal Health is based in Granchina, Calle Guayama, 00917, United States. This is a remote role.
Is this Senior Coordinator, Prior Authorization job remote, hybrid, or on-site?expand_more
Cardinal Health has listed this Senior Coordinator, Prior Authorization role as remote.
How much experience is required for this Senior Coordinator, Prior Authorization role?expand_more
Senior Coordinator, Prior Authorization at Cardinal Health typically requires 3–6 years of relevant experience at the senior level.
What skills do you need for the Senior Coordinator, Prior Authorization role at Cardinal Health?expand_more
Key skills for Senior Coordinator, Prior Authorization at Cardinal Health include Prior Authorization; Insurance Verification; Medical Documentation; Revenue Cycle; Claims; Hipaa; Icd-10; and HCPCS.
What education is required for Senior Coordinator, Prior Authorization at Cardinal Health?expand_more
Educational requirements for this role: High School diploma, GED or equivalent work experience, preferred.
What category does the Senior Coordinator, Prior Authorization role belong to?expand_more
Senior Coordinator, Prior Authorization at Cardinal Health is part of the admin job category on Recrutus.