About The Auctus Group LLC

Who we are:

We’re big on people and culture at the Auctus Group. Our most important role as a company is to provide an amazing working environment for our team. We’ve been work-from-home-warriors since before it was cool. We support (like encourage and fund) continuing education. We match charitable donations. Our whole goal is: work to live not live to work. Oh and we’re weirdos too…we do remote happy hours and have a book club and goofy stuff like that.

Who we’re looking for:

Smart, talented, tech-savvy, experienced, go-getter types. You’ll do well if:

• You like a fast-paced environment,
• You thrive with change and development,
• You like giving feedback,
• You’re a team player,
• You love learning/sleuthing,
• You’re big on accountability.

About The Role

The Authorizations Coordinator is responsible for managing the end-to-end prior authorization and referral process for patient services. This role ensures that authorization requests are accurately initiated, tracked, followed up on, and completed in accordance with payer requirements, medical policies, and client expectations.

The ideal candidate has experience in prior authorizations, medical billing, or revenue cycle management, with strong attention to detail, excellent communication skills, and the ability to manage a high-volume workload in a remote environment.

Key Responsibilities

• Receive, review, and process prior authorization and referral requests accurately and in a timely manner.
• Initiate, track, and follow up on authorization requests from submission through final determination.
• Review patient cases, medical documentation, CPT codes, ICD-10 diagnosis codes, and payer requirements to determine authorization needs and likely outcomes.
• Verify patient demographics, insurance eligibility, benefits, referral requirements, and coverage details.
• Obtain, review, and enter insurance authorizations and referrals prior to patient services.
• Work within EMRs, payer portals, and authorization platforms such as Availity or similar systems.
• Communicate with provider offices, physicians’ offices, insurance representatives, and internal teams to gather required documentation and resolve authorization issues.
• Assist patients, when appropriate, with collecting supporting documents needed for authorization processing.
• Maintain accurate logs of open cases, pending documents, payer follow-ups, action items, and case outcomes.
• Monitor authorization status and follow up with insurance companies to prevent delays in patient care or claim processing.
• Identify and escalate issues related to denials, missing documentation, payer discrepancies, or authorization delays.
• Respond to emails, phone calls, and internal messages in a timely and professional manner.
• Support benefit verification tasks for patients and clients as needed.
• Assist with customer service calls and route inquiries appropriately.
• Maintain productivity expectations, including daily or weekly case submission and follow-up targets.
• Perform other duties as assigned.