Job Title: Remote Manager – Hospital Inpatient Authorization
Location: Fully Remote (U.S. Based)
Position Type: Full-Time | Exempt
Schedule: Monday – Friday, standard business hours (with flexibility for time zones and urgent cases)
About the Role
We are a mission-driven healthcare services firm delivering exceptional revenue cycle and utilization management support to hospitals across the U.S. We are seeking a skilled and experienced Manager – Hospital Inpatient Authorization to lead and coordinate inpatient authorization operations for multiple hospital clients. This fully remote leadership position requires deep knowledge of hospital admitting workflows, payer communication protocols, insurance verification, and inpatient medical necessity criteria.
Key Responsibilities
- Lead a remote team of patient registration and authorization specialists supporting hospital inpatient workflows
- Oversee payer admission notifications, insurance verification, and inpatient authorization submission/follow-up processes
- Serve as the primary liaison between hospital case management teams, payers, and internal reviewers for escalations and complex cases
- Review inpatient clinical documentation to support timely and accurate prior authorization submissions
- Ensure compliance with payer-specific notification timeframes and regulatory requirements (Medicare, Medicaid, Commercial)
- Monitor team productivity and performance through established KPIs and reporting dashboards
- Provide coaching, training, and process improvement guidance to authorization staff
- Maintain and update internal documentation on payer workflows, portals, and authorization grids
- Collaborate cross-functionally with registration, billing, and UM teams to streamline inpatient processing and minimize denials
Required Qualifications
- Minimum 3–5 years of experience in hospital inpatient authorizations, utilization management, or admitting/registration
- Prior management or supervisory experience in a healthcare or hospital setting (remote team leadership a plus)
- Deep understanding of payer notification workflows, medical necessity criteria, and payer-specific policies
- Familiarity with hospital EMR systems (Epic, Cerner, Meditech, etc.) and third-party payer portals (e.g., Availity, UHCprovider, NaviNet)
- Strong knowledge of insurance types, including Medicare FFS, Medicare Advantage, Medicaid, and commercial plans
- Excellent critical thinking, documentation, and escalation management skills
- Must reside in the U.S. and be authorized to work without sponsorship
Preferred Qualifications
- Experience with InterQual or MCG criteria
- RN, LVN, or Clinical background preferred (not required)
- Lean or process improvement experience a plus
- Bilingual (English/Spanish) is a plus
Compensation and Benefits
- Competitive salary (commensurate with experience)
- Health, dental, and vision insurance
- 401(k) with company match
- Paid time off and company-observed holidays
- Company-provided equipment and tools
- Fully remote work environment with flexible scheduling and strong team culture
Job Type: Full-time
Pay: $25.00 - $40.00 per hour
Work Location: Remote
