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Prior Authorization Specialist
2 weeks ago
California Cardiovascular Care Pasadena, United StatesApplicant must be available to work 30 hours per week in person at the Pasadena office but may occasionally have to go to the Glendora office. You must have **one** years of experience in both billing and authorizations. Must be able to work as a team with three other billers, me ...
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Authorization Specialist
1 week ago
REGAL MEDICAL GROUP, INC Northridge, United States**Essential Duties and Responsibilities include the following**: · - "First line" resource for inpatient inquiries. · - Responsible for compiling coordinator audit questionnaires. · - Reflecting current processes and will be responsible for updating and maintaining the questionna ...
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Authorization Specialist
2 weeks ago
Skin and Cancer Institute Palmdale, United StatesOverview: · We are seeking a detail-oriented and organized individual to join our team as an Eligibility Specialist. As an Eligibility Specialist, you will play a crucial role in ensuring accurate and timely eligibility determinations for our clients. This position requires knowl ...
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Clinical Authorization Specialist
2 hours ago
Keck Medical Center of USC Los Angeles, United StatesThe Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient clinic, inpatient admission, ancillary services and/or chemotherapy and other infused treatments as needed in assigned se ...
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Eligibility and Authorization Specialist
3 days ago
Choice Health Group Los Angeles, United States**Responsibilities** · - This role works directly with patients, insurance companies, and clinical departments to verify insurance coverage, obtain proper authorizations. · - Determines deductibles, copayments, coinsurance, CPT and Diagnosis/Procedure Codes, Medical policies, LCD ...
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Prior Authorization Specialist
2 weeks ago
PhyNet Dermatology LLC Orange, United StatesThe Prior Authorization Specialist is responsible for obtaining prior authorizations for all required procedures and maintaining accurate and timely record-keeping of all related documents and actions. · **ESSENTIAL FUNCTIONS**: To perform this job, an individual must perform eac ...
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Eligibility and Authorization Specialist
2 weeks ago
GrandCare Health Services Pasadena, United StatesGrandCare Health Services is a physician-trusted leader in post-surgical rehabilitation delivered in the comfort of patients' own homes. We are recognized by the Centers for Medicare and Medicaid Services as a 5-Star agency, placing us in the top 10% nationally. Our experienced c ...
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Eligibility and Authorization Specialist
2 weeks ago
GrandCare Health Services Pasadena, United StatesGrandCare Health Services is a physician-trusted leader in post-surgical rehabilitation delivered in the comfort of patients' own homes. We are recognized by the Centers for Medicare and Medicaid Services as a 5-Star agency, placing us in the top 10% nationally. Our experienced c ...
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Eligibility and Authorization Specialist
1 week ago
GrandCare Health Services Pasadena, United StatesJob Description · Job DescriptionGrandCare Health Services is a physician-trusted leader in post-surgical rehabilitation delivered in the comfort of patients' own homes. We are recognized by the Centers for Medicare and Medicaid Services as a 5-Star agency, placing us in the top ...
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Authorization/billing Specialist
2 hours ago
Prism Behavioral Solutions Woodland Hills, United StatesPBS is seeking a bilingual (Spanish speaking) billing/authorization coordinator for our HQ office in Woodland Hills. · **Job Description**: · The billing/authorization coordinator job duties includes the following, but is not limited to: · ► Intake service specialist · ►Program c ...
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Authorization Specialist
1 week ago
Randstad North America, Inc. Woodland Hills, United States[ " · . Initiate authorization requests for outpatient and inpatient services in accordance with the prior authorization list. · . Route to appropriate staff when needed. · . Verify eligibility and benefits · . Answer phone queues · . Process Authorization, Specialist, Patient ...
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authorization specialist
1 week ago
Skin and Cancer Institute Palmdale, United StatesJob Description · Job DescriptionAn authorization specialist usually works for a company that deals with insurance claims, such as a hospital, automotive shop, or private medical practice. The authorization specialist will take insurance information from clients and will determin ...
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authorization specialist
3 weeks ago
Randstad Woodland Hills, United Statesauthorization specialist. · + woodland hills , california · + posted 8 days ago · **job details** · summary · + $22 - $23 per hour · + temporary · + high school · + category healthcare support occupations · + referenceAB_4521427 · job details · A trusted client of Randstad's has ...
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authorization specialist
3 weeks ago
Randstad Woodland Hills, United Statesauthorization specialist. · + woodland hills , california · + posted 7 days ago · **job details** · summary · + $22 - $23 per hour · + temporary · + high school · + category healthcare support occupations · + referenceAB_4521427 · job details · A trusted client of Randstad's has ...
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authorization specialist
3 weeks ago
Randstad Woodland Hills, United Statesauthorization specialist. · + woodland hills , california · + posted 6 days ago · **job details** · summary · + $22 - $23 per hour · + temporary · + high school · + category healthcare support occupations · + referenceAB_4521427 · job details · A trusted client of Randstad's has ...
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Authorization specialist
2 weeks ago
Randstad Woodland Hills, United States TEMPORARY, Full timeA trusted client of Randstad's has an immediate opening for an experienced Authorization Specialist. This is a remote role, but the right candidate will be local to Woodland Hills, CA, as onsite meetings will be required. Must be able to work a flexible schedule with evenings and ...
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Clinical Authorization Specialist
2 weeks ago
University of Southern California Los Angeles, United States Full timeThe Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient clinic, inpatient admission, ancillary services and/or chemotherapy and other infused treat Clinical, Authorization, Spec ...
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Authorization Specialist
1 week ago
Randstad USA Woodland Hills, United States TEMPORARY, Full timeA trusted client of Randstad's has an immediate opening for an experienced Authorization Specialist. This is a remote opportunity, but MUST be located near Woodland Hills, CA or Sacramento, CA to come in for occassional team meetings. Schedule is Tuesday - Saturday 8 a.m. - 5 p.m ...
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Clinical Authorization Specialist
1 week ago
University of Southern California Los Angeles, United States Full timeThe Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient clinic, inpatient admission, ancillary services and/or chemotherapy and other infused treatments as needed in assigned se ...
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authorization specialist
1 week ago
Skin and Cancer Institute Palmdale, United StatesJob Description · Job DescriptionOverview: · We are seeking a detail-oriented and organized individual to join our team as an Eligibility Specialist. As an Eligibility Specialist, you will play a crucial role in ensuring accurate and timely eligibility determinations for our clie ...
Eligibility and Authorization Specialist - Pasadena, United States - GrandCare Health Services
Description
Job DescriptionJob Description
GrandCare Health Services is a physician-trusted leader in post-surgical rehabilitation delivered in the comfort of patients' own homes.
We are recognized by the Centers for Medicare and Medicaid Services as a 5-Star agency, placing us in the top 10% nationally.
Our experienced clinicians collaborate closely with patients' physicians to develop a personalized plan of care specific to patient needs Our tailored, concierge approach is proven to promote faster healing, reduce stress and anxiety, and get patients moving again.
GrandCare employees can be proud to know that their work is meaningful and dramatically changes lives for the better.This position is an outstanding launching point for people with solid customer service, phone line skills, and tech skills to move up in the medical administrative professional world.
As a Medical Administrative Assistant here is what you may expect:Job Summary:
Under the direction of the Clinical Supervisor, the Eligibility and Authorization Specialist will be responsible for ensuring that payers are prepared to reimburse GrandCare for scheduled services in accordance with the payer-provider contract.
Essential Functions:
Unless specifically required by law, rule, regulation, or local ordinance, all job attributes are preferred. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Obtain prior authorizations from third-party payers in accordance with payer requirements.
Remain current on all regulations, policies and procedures and process changes that are essential to completing assigned daily tasks.
Verify patient's insurance and benefits information.
Performs any written and/or verbal communication necessary to exchange information with designated contacts.
Comply with HIPAA regulations, as well as Company policies and procedures regarding patient privacy and confidentiality.
Work with other departments to gather the clinical information required by the payer to authorize services.
Work with other departments to support appeal efforts for authorization-related denials.
Maintain accurate records of authorizations within the EMR.
Contact patients to gather demographic and insurance information as needed, and update patient information within the EMR.
Identify patients who will need to receive Medicare Advance Beneficiary Notices of noncoverage (ABNs).
Perform other registration duties as required.
Required Education, Experience & Professional Skills:
Associate degree in Business Administration or Healthcare-related field, preferred OR 3 years of related work experience
1 year of experience with medical terminology and healthcare insurance processes, home health preferred
Excellent communication and customer service skills
Proficiency in the use of healthcare information systems
Ability to prioritize and multitask
Ability to maintain professional tone at all times when communicating with patients and payer representatives
Critical problem solving skills
Experience within financial clearance setting
Strong attention to detail
Experience with MS Office Suite, including Word, Excel, PowerPoint, Outlook, and Teams
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