Authorization Coordinator II

Internal Opportunities at WCC•Wilmington, CA

3d•Onsite

About The Position

Join Wilmington Community Clinic! Have you ever wanted to be a part of something bigger? Have you ever wanted to make a difference? At Wilmington Community Clinic, here you can. WCC provides quality, non-discriminatory primary care, mental health, dental and women’s health services to improve the health and well-being of all served – regardless of their ability to pay. We have served patients in and around Wilmington and Los Angeles for over 40 years. Our multi-generational impact makes us proud of the services we provide, and we put patient care front and center - it's The Wilmington Way! Position Summary The Authorization Coordinator II is responsible for managing complex authorization requests, resolving payer-related issues, and supporting the overall efficiency and integrity of the authorization process. This role serves as a subject matter expert in payer requirements, prior authorization workflows, and referral coordination. The Authorization Coordinator II works independently to resolve denials, reduce delays, and ensure continuity of care, while supporting team training and process improvement initiatives.

Requirements

High school diploma or equivalent education required
Minimum 3–4 years of experience in authorizations, referrals, or care coordination required
Strong knowledge of prior authorization processes, payer requirements, and denial management
Proficiency with EHR systems and reporting tools (Epic preferred)
Bilingual English/Spanish preferred.

Nice To Haves

Prior experience in an FQHC or similar setting strongly preferred
Experience with Medi-Cal managed care, specialty networks, and public health programs strongly preferred
Advanced problem-solving and critical thinking skills
Ability to manage complex, high-volume workflows independently
Strong communication and interpersonal skills

Responsibilities

Process and oversee complex prior authorization requests, including high-cost procedures, specialty services, and out-of-network referrals
Investigate and resolve authorization denials, including preparation of appeals, coordination of peer-to-peer reviews, and resubmissions
Serve as primary point of contact for payer-related issues, including Medi-Cal managed care plans and specialty programs
Monitor authorization work queues and identify delays, trends, or workflow gaps; take action to ensure timely resolution
Meet established turnaround times for authorization submission and follow-up
Ensure timely follow-up on all pending authorizations and support “closing the loop” on approved services
Collaborate with providers to obtain necessary clinical documentation to support authorization approvals
Coordinate with referral staff and external specialists to ensure continuity of care and timely service delivery
Support eConsult workflows and specialty programs (e.g., Every Woman Counts) as applicable
Train and mentor Authorization Coordinator I staff; provide guidance on workflows, payer requirements, and issue resolution
Assist in development and refinement of authorization workflows, policies, and tracking tools
Partner with Quality Improvement (QI) and leadership teams to monitor performance metrics and improve access to care
Maintain accurate and complete documentation in the EHR and tracking systems
Ensure compliance with all regulatory, payer, and organizational requirements
Participate in meetings, audits, and performance improvement initiatives
Perform other duties as assigned in support of WCC’s mission.