Prior Authorization Coordinator at University Physicians' Association – Knoxville, Tennessee

Join a Team That Makes a Difference for Kids & Families

At GI for Kids, you’ll play a key role in helping children access the care they need. As our Prior Authorization Coordinator, you’ll serve as the vital link between medical providers, insurance companies, and patient families—ensuring treatments and procedures are approved quickly, accurately, and with compassion.

If you’re detail-oriented, love problem-solving, and enjoy supporting both patients and clinical teams, this role may be perfect for you.

Why You’ll Love Working Here!

• No nights, weekends, or on-call
• Monday–Friday, standard business hours
• Office closed for major holidays (paid holidays)
• Comprehensive benefits package, including:
  • Medical, Dental, and Vision Insurance
  • Generous PTO & Sick Time
  • 401(k) with company match
  • And more!

• Verify Insurance Coverage
  Confirm patient eligibility, benefits, co-pays, and deductibles before services are scheduled.
• Submit Authorization Requests
  Prepare and submit accurate, complete prior authorization requests using payer portals, fax, or phone—including all necessary clinical documentation, ICD-10, CPT, and HCPCS codes.
• Track and Manage Status Updates
  Follow up on pending authorizations, ensuring timely approvals and preventing delays in patient care.
• Handle Denials & Appeals
  Review denial reasons and initiate appeals by gathering additional documentation or coordinating peer-to-peer reviews when needed.
• Communicate with Providers & Patients
  Keep clinical staff updated on authorization status and help patients understand their insurance requirements and potential costs.
• Maintain Accurate Records
  Enter and update authorization details in the EHR or Practice Management system for smooth billing and scheduling.

Education:

• High School Diploma or GED required
• Associate or bachelor’s degree in healthcare administration or related field preferred

Experience:

• 1–3 years in medical billing, insurance verification, prior authorization, or a clinical office setting

Knowledge & Technical Skills:

• Familiarity with medical terminology, anatomy, and coding (ICD-10, CPT, HCPCS)
• Skilled in insurance portals such as Availity or CoverMyMeds
• Experience with EHR systems

Essential Strengths:

• Strong attention to detail and accuracy
• Excellent time management and organization
• Problem-solving mindset with the ability to navigate complex insurance guidelines
• Clear, professional communication—both written and verbal