Job Description

Job Description

Job Title: Clinical Administrative Coordinator (Pre-Authorization / Prior Authorization Specialist)

Job Type: Fulltime

Location: Atlanta GA

Purpose of Job:

Positions in this role are responsible for determining if prior authorization is required and whether it can be decisional or requires additional clinical review. The role supports clinicians by contacting healthcare providers and/or members to verify authorizations or referrals, setting up cases, and documenting findings. Responsibilities also include initial triage of members, administrative intake, and collaboration with hospitals and clinical teams.

Primary Responsibilities:

• Meet production, quality, and regulatory expectations in a high-volume environment.
• Ensure cases are accurately set up and document all required information.
• Review, research, and determine if cases can be decisioned or require further clinical review.
• Demonstrate proficiency and decision-making skills by solving complex problems using available resources (documents, medical policies, SOPs, etc.).
• Make outbound calls to providers and/or members as needed to obtain information or coordinate provider availability.
• Perform other duties as assigned by management.

Qualifications:

Required:

• High School Diploma or GED minimum.
• 1+ years professional experience in an office or healthcare environment.
• Prior customer service experience, including making outbound calls.
• Proficient computer skills, including Microsoft Outlook, Word, and Excel.
• Ability to work an 8-hour shift Monday-Friday between 7am-7pm; alternate shifts (Tuesday-Saturday or Sunday-Thursday) may be available.
• Flexibility to work outside standard hours due to business needs.
• Ability to troubleshoot and set up computer equipment independently.
• Must have a designated, secure workspace compliant with data privacy standards.
• Must work from an approved office location or have a reliable, dedicated high-speed internet connection (minimum 1.5 Mbps download/upload). Exceptions require management approval.

Preferred:

• Experience with back-office medical platforms or authorization systems.
• Healthcare industry experience, including knowledge of medical terminology, ICD-10, CPT codes, Medicare, or Medicaid services.
• Clerical or administrative support experience.
• Ability to quickly learn new computer systems or applications.

Soft Skills:

• Strong written and verbal communication skills.
• Excellent critical thinking and problem-solving abilities.
• Highly organized with strong attention to detail.
• Analytical mindset with sound judgment and decision-making skills.
• Ability to prioritize tasks, multitask, and work independently.
• Self-motivated with the ability to focus and learn in a remote setting.
• Team-oriented attitude.

Thanks & Regards

Misam Raza

Sr. Talent Acquisition Specialist

Diverse Lynx | 300 Alexander Park Suite| #200|Princeton, NJ 08540

Mobile- 732-582-8414

Office - 732-452-1006 , Ext:285

Email - misam.raza@diverselynx.com | URL -

LinkedIn- linkedin.com/in/connect2misam

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