Authorization Specialist I

Immediate need for a talented Authorization Specialist I . This is a 06+months contract opportunity with long-term potential and is located in  Los Angeles, CA , Sacramento, CA (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-65795

Pay Range: $19 - $20/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• NOTE: The candidate will be asked to work from office if any internet issues arise. Locations are:
• 21281 Burbank Blvd, Los Angeles, CA 91367
• 4191 East Commerce Way - Building A, Sacramento, CA 95834
• Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline.
• Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.
• Will need to review documents received via fax and extract information needed to build authorization.
• Occasionally doing outreach to provider to obtain clarification of request or missing information.
• Required to send out notification of determination and adhere to strict deadlines.
• Will need ability to have good communication skill both verbal and written as letter will need to be created for providers per medical guidelines.
• Supports authorization requests for services in accordance with the insurance prior authorization list.
• Supports and performs data entry to maintain and update authorization requests into utilization management system.
• Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines.
• Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination.
• Remains up to date on healthcare, authorization processes, policies, and procedures.
• Performs other duties as assigned.
• Complies with all policies and standards.

Key Requirements and Technology Experience: 

• Key Skills;  Looking for experience in intake and authorization, some Medi-Cal knowledge would be helpful for this role as well as pas medical experience.
• Medical office background / Medical terminology is required.
• Experience with Authorizations, MS Excel and Word is required.
• Long Term Custodial experience preferred.
• Understanding of medical terminology and insurance preferred.
• Requires a High School diploma or GED.
• Team player – someone willing to learn, has strong communication skills, etc.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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