Authorizations Coordinator (Pediatric Therapy) — Philippines | Remote | Full-Time

About the Role: We’re hiring an experienced Authorizations Coordinator to manage all new and ongoing authorizations for a pediatric therapy medical practice serving families with young children. This role is critical to keeping therapy services uninterrupted by ensuring authorizations are obtained correctly, tracked accurately, renewed on time, and communicated clearly across scheduling, intake, clinicians, and billing.

The ideal candidate has direct experience with therapy authorizations (OT/PT/ST; ABA is a plus), understands payer requirements and common pitfalls, and is highly organized with strong follow-through. You’ll own the authorization workflow end-to-end and help build a scalable system as volume grows.

Key Responsibilities

Authorization Management (Primary Focus)
• Obtain and manage authorizations for new therapy evaluations and ongoing therapy visits (OT/PT/ST; ABA a plus).
• Verify authorization requirements by payer and plan; submit complete authorization requests with required documentation.
• Track authorizations by patient, discipline, CPT codes, visit limits/units, date ranges, and frequency.
• Monitor utilization and proactively request extensions/renewals before visits run out.
• Prevent service interruptions by coordinating authorization status with scheduling and clinical teams.

Documentation & Submission
• Request and compile required documentation (prescriptions/referrals, eval reports, plan of care, progress notes, standardized testing results, etc.).
• Submit authorizations via payer portals, phone, fax, or other payer-required methods; maintain organized confirmation records.
• Ensure requests are accurate (provider info, NPI, diagnosis codes, CPT codes, modifiers, frequency/duration, start dates).

Follow-Up & Resolution
• Follow up on pending requests; escalate as needed to avoid delays.
• Resolve issues such as missing documentation, incorrect member info, authorization denials, partial approvals, and mismatched CPT codes.
• Document payer communications thoroughly and maintain a clear audit trail.

Cross-Team Coordination
• Communicate authorization approvals/updates to scheduling and billing promptly.
• Partner with intake to ensure benefits/eligibility details align with authorization requirements.
• Support clinicians by guiding what documentation is needed to support medical necessity for renewals.

Reporting & Process Improvement
• Maintain weekly authorization dashboards: pending, approved, expiring soon, denials, turnaround times.
• Identify payer-specific trends and bottlenecks; recommend improvements to workflows and templates.
• Build and maintain SOPs/checklists to ensure consistent, scalable execution.

Required Experience & Skills
• 2+ years experience managing therapy authorizations in a pediatric therapy setting (OT/PT/ST required; ABA a plus).
• Strong understanding of authorization concepts: visit limits/units, date ranges, medical necessity, renewals, and payer workflows.
• Experience using payer portals and managing documentation requirements.
• Highly organized with excellent tracking skills (spreadsheets/work queues) and strong attention to detail.
• Strong written and verbal English for payer communications and internal updates.
• Comfortable working independently and managing high volume with deadlines.

Nice to Have
• Experience with EMR systems commonly used in therapy practices (experience with Ensora / Fusion Web Clinic is a plus).
• Familiarity with typical therapy CPT codes and how they relate to authorizations (without needing constant supervision).
• Experience coordinating referrals/prescriptions and handling school/regional programs (if applicable).
• Experience building SOPs and training others.

What Success Looks Like (First 60–90 Days)
• Clean, reliable authorization tracking system in place with clear status visibility.
• Fewer canceled visits due to missing/expired authorizations.
• Renewals submitted early and consistently, with strong documentation support.
• Clear communication rhythm with scheduling/clinical/billing teams.
• Payer turnaround times improve through consistent follow-up and escalation.

Work Setup & Compensation
• Remote (Philippines-based)
• Full-time with overlapping hours for collaboration
• Competitive pay based on experience

How to Apply

Please submit:
1. Resume/CV
2. A short cover letter describing your experience with pediatric therapy authorizations (OT/PT/ST)
3. A brief list of payer portals/workflows you’ve used (generic is fine)
4. (Optional) A sample of how you track authorizations (template screenshot with private info removed)