Referral & Authorization Care Coordinator

Role overview

Oshi Health is seeking a Care Coordinator focused on prior authorizations and referrals to support back-office coordination for members. This position handles referral administration, prior authorizations, specialty pharmacy and infusion coordination, and medical records management to help carry out clinical plans and keep care moving smoothly. The role calls for strong organization, precise follow-through, and clear communication to ensure referrals and authorizations are obtained, tracked, and closed out effectively.

Schedule and work location

This is a full-time remote role with a schedule of Monday through Friday, 12:00 PM to 8:00 PM EST. Hiring is limited to candidates who currently live in and will continue to reside in one of the following states: Arizona, Delaware, Florida, Georgia, Idaho, Indiana, Louisiana, Missouri, New Hampshire, North Carolina, South Carolina, Tennessee, Texas, Vermont, or Virginia. The role is remote-first and intended to be performed from home anywhere in the United States, subject to the state eligibility requirement.

What you'll handle

You will work closely with a multidisciplinary care team to support whole-person member care, keep referral and authorization records up to date, and help remove barriers that could delay treatment. The work includes gathering and sharing complete documentation, coordinating with outside providers and specialty pharmacies, supporting appeals for denials, and maintaining reports that help the team improve operations.

Compensation and benefits

The compensation range for this role is $47,000 to $52,000 USD, with a salary range also noted as $45,000 to $52,000 based on experience. Benefits include employer-sponsored medical, dental, and vision coverage, unlimited PTO, 11 paid company holidays, eligibility to contribute to a 401(k), tailored professional development as the company grows, and access to Overalls life concierge support.

About Oshi Health

Oshi Health is a virtual digestive health practice focused on transforming gastrointestinal care through a digital clinic model. The organization combines multidisciplinary clinical support and technology to deliver personalized care for people living with chronic digestive conditions, with an emphasis on identifying triggers and using evidence-based treatments such as medication, nutrition changes, and mental health support.

Additional notes

This role description may change depending on business needs. Oshi Health is an equal opportunity employer and maintains a workplace free from discrimination and harassment. Employment decisions are made without regard to protected characteristics. The company also warns candidates that it will not contact applicants by text or messaging apps such as WhatsApp, Signal, or Telegram, and it will never request bank details, ask candidates to cash a check, or require purchase of software or equipment during hiring. Questions about suspicious outreach can be sent to [email protected].

Responsibilities

• Partner with doctors, nurse practitioners, registered dietitians, behavioral health providers, and health coaches to support coordinated member care.
• Track, organize, and communicate referrals, prior authorizations, and medical records to keep care teams informed and patients safe.
• Enter and verify referral and authorization details, including demographics, insurance data, and clinical documentation for external providers and specialty pharmacies.
• Use knowledge of insurance rules and prior authorization workflows to help members move through care without unnecessary delays.
• Apply CPT and ICD-10 coding knowledge to secure authorizations promptly while working within payer policy requirements.
• Submit and follow up on appeals for denied authorizations to improve member outcomes.
• Coordinate with pharmacy support services so members receive assistance throughout the authorization process.
• Help members access services while maintaining close communication with the care coordination team.
• Maintain reports and monitor data to surface wins and identify opportunities to improve operational processes.

Requirements

• At least 2 to 3 years of experience in healthcare coordination, care coordination, or case management in a remote digital healthcare setting.
• A completed degree in a health- or science-related field such as biology, psychology, health science, nutrition, or nursing.
• Strong command of healthcare terminology and a practical understanding of clinical concepts.
• Knowledge of health insurance plans and coverage, including the ability to explain benefits in a consumer-friendly way.
• Comfort using common workplace tools such as Zoom, Slack, and Office or similar software, along with electronic charting in EMR/EHR systems.
• Preferred experience in telehealth or digital health.
• Preferred strong critical thinking skills with the ability to triage issues accurately and escalate when needed.
• Preferred background in a high-growth startup or mission-driven healthcare environment.

Perks

• Employer-covered medical, dental, and vision insurance.
• Unlimited paid time off plus 11 company holidays.
• Ability to participate in a 401(k).
• Remote-first setup with work-from-home flexibility across the US, within the stated state restrictions.
• Customized professional development opportunities.
• Access to Overalls life concierge support.

Eligibility

Applicants should have 2 to 3 years of relevant healthcare coordination or case management experience, a completed degree in a health or science discipline, and current residency in one of the approved hiring states. Candidates should be comfortable working in a remote, fast-paced, mission-driven healthcare environment and have the language, insurance, and systems knowledge needed for referral and authorization work.

Equal opportunity and safety notice

Oshi Health states that it is committed to equal employment opportunity and a respectful, discrimination-free workplace. The company also includes a hiring safety notice explaining that official communication will come only through email and that candidates should be alert to fraudulent requests involving money, banking information, software, or equipment.