It usually starts with a two-week notice. Sometimes it is a text on a Sunday night. Sometimes she just does not come back after a leave.

However it happens, the practice manager gets the same sinking feeling: nobody else really knows where the prior auths stand.

The work does not leave with her. The patients still need their biologics, their imaging, their procedures. What leaves is the knowledge of where every request is, what each payer said, and which deadline is coming up next week. In most independent practices, that knowledge lives in one person's head, one person's inbox and one person's sticky notes.

29% of medical practices reported higher staff turnover in 2026 than in 2025 (MGMA Stat poll)
Front desk & billing are among the roles practices name when turnover rises
1 person is often the only one who knows where every prior auth stands

MGMA put it plainly: turnover is "an operations problem as well as an HR problem," and each departure can "age claims work" and "drain institutional knowledge." Prior authorization is where that drain hurts most, because every request is on a clock.

What Actually Lives in Your Coordinator's Head

Ask your coordinator to write down everything she knows about prior auth, and you would get a document nobody has ever seen. It includes:

  • Which requests are submitted and waiting, and the payer reference number for each one
  • Which payer portals she uses, and which payers still want a fax
  • Which approvals expire in the next 60 days and need a renewal started
  • Which denials are sitting in the queue, and what the payer actually said
  • Which appeal or resubmission deadlines are coming up
  • The quirks: the payer that always asks for the last two office notes, the one that loses faxes, the rep who actually calls back

None of this is written down anywhere because nobody ever asked. Prior auth is usually one bullet point in a long job description, under scheduling, check-in and phones. It works because she makes it work. Until she is gone.

What Breaks in the First 30 Days

When the coordinator leaves, three things tend to go wrong, quietly and in this order.

  • Requests go silent. Submitted requests that were waiting on the payer stop being followed up. Nobody notices until a patient calls to ask why they have not heard anything.
  • Approvals lapse. Renewals that she would have started 30 days out never get started. The patient shows up for their next infusion or refill and the authorization has expired.
  • Denial deadlines pass. Denials that needed a fix, a resubmission or an appeal sit untouched. By the time someone finds them, the window to act has closed and the revenue is gone.

"Nothing about this is dramatic. That is the problem. It does not look like a crisis until the write-offs show up a quarter later."

The Two-Week Test

Here is a simple test any practice manager can run today. Without asking your coordinator, can you answer these five questions?

  1. How many prior auth requests are open right now, and with which payers?
  2. Which requests have been waiting on a payer for more than 10 days?
  3. Which approvals expire in the next 30 days?
  4. Which denials are open, what did the payer say, and what is the next step on each one?
  5. What is the next deadline, and whose name is on it?

If you can answer all five in under ten minutes, your practice is in good shape. If you would have to ask her, or dig through her email, your prior auth process belongs to a person, not to the practice. That is the risk to fix, and it is much cheaper to fix before she gives notice than after.

How to Make the Queue Belong to the Practice

You do not need a bigger team to fix this. You need the work to live somewhere everyone can see it.

  • Give prior auth a named owner and a named backup. Not "whoever is free." Two names, written down, so coverage is a plan and not a scramble.
  • Keep one shared queue. Every request, its status and its payer reference number in one place that the manager and the backup can open on any day. Not a personal spreadsheet. Not someone's inbox.
  • Record what the payer actually said. On every denial, keep the payer's own words, not a summary. The next person needs to know exactly what was asked for.
  • Put deadlines where they cannot hide. Expiring approvals and open denial deadlines should surface on their own, sorted by what is due first.
  • Review the queue together once a week. Fifteen minutes between the manager and the coordinator. It keeps the manager current, and it is how the backup learns the work before they ever need to do it.

Where MedMojo™ Fits

This is the problem MedMojo™ was built around. Every prior auth lives in one place, across every payer, from request to decision. A "Needs you today" list puts deadlines first. Payers that go quiet are flagged at 10 and 21 days. Expiring approvals surface before they lapse. Every denial keeps the payer's own words and a clear next step.

And because the history belongs to the practice, not to a login, a new coordinator can open MedMojo™ on day one and see exactly where everything stands. The practice manager can see it too, any day, without asking anyone.

Your coordinator is one of the most important people in your practice. The goal is not to replace her. It is to make sure that when she takes a vacation, gets sick or moves on, your patients and your revenue do not go with her.

Source: MGMA Stat, "Stabilized but not solved: Staff turnover in medical practices looking no better, no worse in 2026," May 26, 2026 poll, 303 responses.