Medical Authorization Assistant

1 month ago

Orange, United States The Midtown Group Full time
Job DescriptionJob Description

Our client, a well-respected California based Healthcare Network, is seeking a highly motivated an experienced Medical Authorization Assistant (Prior Authorization) to join its team.  The Medical Authorization Assistant (Prior Authorization) will provide office and referral management services and serve as a contact between members, physicians, providers and staff. The incumbent will process initial intake of information, assist with authorization functions and gather information. The incumbent will be responsible for reviewing and processing requests for authorization and notification of medical services from health professionals, clinical facilities and ancillary providers. The incumbent monitor tasks related to prior authorization and referral process. Additionally, the incumbent will be responsible for applying the network’s medical criteria and policies/procedures to authorization or referral requests from medical professionals, clinical facilities and ancillary providers. The incumbent will directly interact with provider callers, acting as a resource for their needs. The incumbent will operate under the direction of the licensed nurse. 

**This position is eligible for telework in Southern California.**  

** The schedule will be Thursday-Monday with Tuesday/Wednesday off**

Duties & Responsibilities:
85% - Medical Authorization Receives referral requests via fax, phone or electronically and enters new service request information into the authorization system. Collects additional information from members and providers to complete referral information. Authorizes requested services according to authorization guidelines, performing data entry into the authorization system and verifying eligibility. Contacts the health networks and Customer Service regarding health network enrollments. Assists the Medical Case Managers in gathering medical records, obtains appropriate coding for diagnosis and procedures and follows up on phone calls as directed by the authorization nurse. Documents all contacts and case information in the system using the standard charting format. Performs data entry into the appropriate databases for monitoring, tracking and trending of events and other relevant databases as needed. 
10% - Administrative Support Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. 
5% - Completes other projects and duties as assigned. 

Minimum Qualifications:
High School diploma or equivalent required.
2 years of experience in a health care or managed care setting required.
An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

Preferred Qualifications:
Bilingual in English and in one of the defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese).
Prior authorization and utilization management process experience.

Required Licensure / Certifications: N/A

Knowledge & Abilities:
Develop rapport and establish and maintain effective working relationships with leadership and staff and external contacts at all levels and with diverse backgrounds.   Work independently and exercise sound judgment. Communicate clearly and concisely, both orally and in writing. Work a flexible schedule; available to participate in evening and weekend events. Organize, be analytical, problem-solve and possess project management skills. Work in a fast-paced environment and in an efficient manner. Manage multiple projects and identify opportunities for internal and external collaboration. Motivate and lead multi-program teams and external committees/coalitions. Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):
Ability to visually read information from computer screens, forms and other printed materials and information.
Ability to speak (enunciate) clearly in conversation and general communication.
Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting. Lifting and moving objects, patients and/or equipment 10 to 25 pounds
 

Company DescriptionOur client has a great internal culture, and they are a company you can grow withCompany DescriptionOur client has a great internal culture, and they are a company you can grow with

  • Medical Authorization Assistant

    4 weeks ago

    Orange, United States VGroup Inc Full time

    Job DescriptionJob DescriptionClient: CalOptima Health Job Title: Medical Authorization Assistant Duration: 06 Months Start Date: ASAP Location: 505 City Parkway West, CA(Onsite) Position Type: Contract Interview Type: In Person/Web Interview Ceipal ID: CAL_HD206_BTJob Description: CalOptima Health is seeking a highly motivated an experienced Temp-Medical...

  • Medical Authorization Assistant

    2 months ago

    Orange, United States The Midtown Group Full time

    Job DescriptionJob DescriptionOur client, a well-respected California based Healthcare Network, is seeking a highly motivated and experienced Medical Authorization Assistant (Prior Authorization) to join its team.  The Medical Authorization Assistant (Prior Authorization) will provide office and referral management services and serve as a contact between...

  • Prior Authorization Coordinator

    21 hours ago

    Orange, California, United States Regal Medical Group Full time

    Job SummaryThe Prior Authorization Coordinator will play a crucial role in facilitating the referral process, ensuring that patients receive the right care at the right time in the right setting. This position requires strong organizational skills, attention to detail, and the ability to work in a fast-paced environment.Key ResponsibilitiesReferral...

  • Bilingual Medical Authorization Coordinator

    2 weeks ago

    Orange, California, United States Ultimate Staffing Full time

    Position Overview:We are looking for a dedicated Medical Authorization Coordinator who will deliver essential office and case management support services. This role acts as a vital link between members, healthcare providers, nursing facilities, community organizations, and our internal team.Key Responsibilities:- Facilitate communication between various...

  • Healthcare Authorization Coordinator

    2 weeks ago

    Orange, California, United States The Midtown Group Full time

    Job OverviewOur client, a reputable Healthcare Network based in California, is in search of a dedicated and experienced Healthcare Authorization Coordinator (Prior Authorization) to enhance their operations. The Healthcare Authorization Coordinator will be responsible for managing office and referral processes, acting as a liaison among members, healthcare...

  • Medical Assistant

    3 weeks ago

    Orange, United States 9992 Full time $25 - $26

    Job DescriptionJob DescriptionThe Medical Authorization Assistant (Prior Authorization) will provide office and referral management services and serve as a contact between members, physicians, providers and CalOptima Health staff. The incumbent will process initial intake of information, assist with authorization functions and gather information. The...

  • Authorization Specialist

    16 hours ago

    Orange, California, United States University of California, Irvine Full time

    Job SummaryWe are seeking a highly skilled Authorization Coordinator to join our team at the University of California, Irvine. As an Authorization Coordinator, you will play a critical role in ensuring that all necessary authorizations are obtained in accordance with established guidelines.ResponsibilitiesVerify eligibility and obtain benefit information for...

  • Medical Assistance Vehicle Operator

    6 days ago

    Orange, New Jersey, United States Bell Medical Transport Full time

    Position OverviewBell Medical Transport is seeking dedicated individuals for the role of Medical Assistance Vehicle Operator. This position requires a commitment to high standards of service and professionalism.Key ResponsibilitiesAs a Medical Assistance Vehicle Operator, you will be responsible for:Safely transporting patients and medical...

  • Medical Assistance Vehicle Operator

    2 weeks ago

    Orange, New Jersey, United States Bell Medical Transport Full time

    Position OverviewBell Medical Transport is seeking dedicated individuals for the role of Medical Assistance Vehicle Operator. This position requires a commitment to providing exceptional service while ensuring the safety and comfort of patients during transport.Key ResponsibilitiesAs a Medical Assistance Vehicle Operator, you will be responsible for:Safely...

  • Referral Coordinators and Medical Scribes

    2 weeks ago

    Orange, California, United States ZAND MEDICAL PARTNERS Full time

    Job DescriptionReferral CoordinatorsPosition Overview:A dynamic Internal Medicine practice is seeking experienced Referral Coordinators to enhance our patient care services.Key Responsibilities:Facilitate patient referrals by coordinating appointments and collaborating with insurance providers and healthcare professionals to ensure seamless communication of...

  • Medical Assistance Vehicle Operator

    6 days ago

    Orange, New Jersey, United States Bell Medical Transport Full time

    Position OverviewBell Medical Transport is seeking qualified candidates for the role of Medical Assistance Vehicle Operator. This position involves providing essential transportation services while ensuring the safety and comfort of patients.Candidate RequirementsPersonal Qualifications:Applicants must be at least 21 years of age.Maintain a professional...

  • Medical Assistant/Admit Coordinator

    1 day ago

    Orange, California, United States University of California, Irvine Full time

    Job SummaryWe are seeking a highly skilled Medical Assistant/Admit Worker to join our team at the University of California, Irvine. As a Medical Assistant/Admit Worker, you will play a critical role in providing exceptional patient care and support in our outpatient clinical setting.Key ResponsibilitiesPerform non-licensed medical care in an assigned...

  • Medical Assistant

    3 months ago

    Orange, United States Benevolence Health Centers Full time

    Job DescriptionJob DescriptionWe are seeking to hire a Medical Assistant to add to our team to help us keep growing. If you're dedicated and ambitious, you would love working with us. Make your next career move with us.ResponsibilitiesReceive and direct phone calls, schedule appointments, check-in patients, obtain necessary patient information to file...

  • Medical Assistant

    3 months ago

    Orange, United States CIBD Full time

    Job DescriptionJob DescriptionWe, at the Center for Inherited Blood Disorders (CIBD), are a mission-driven organization improving the quality of life for people with blood disorders and their families. When choosing CIBD, you can be part of a growing organization dedicated to improving public health and committed to your professional development.Job...

  • Medical Assistant

    3 days ago

    Orange, California, United States KPC GLOBAL MEDICAL CENTERS INC. Full time

    Job SummaryKPC GLOBAL MEDICAL CENTERS INC. is seeking a skilled and compassionate Nursing Assistant to join our healthcare team. As a Nursing Assistant, you will play a vital role in providing high-quality patient care and supporting our medical staff.Key ResponsibilitiesAssist patients with activities of daily living, including bathing, dressing, and...

  • Medical Assistant

    2 months ago

    Orange, United States Pacific Neuropsychiatric Specialists Inc Full time

    Job DescriptionJob DescriptionBenefits:Dental insuranceHealth insurancePaid time offVision insurance We are seeking a motivated and like-minded Medical Assistant, also known here as our Patient Care Coordinators, with clear goals of working as a full treatment team member with other medical professionals and advancing within our culture in the fast-paced and...

  • Medical Assistant

    1 week ago

    Port Orange, United States Conviva Full time

    As a *Medical Assistant*, you will be a part of the Clinical Care Team and engage our patients to develop lifelong well-being and health. The Medical Assistant makes a difference in people’s lives, administers prescribed medical treatment and personal care services to ill, injured, convalescent, and disabled persons under direction of a Physician.*Job...

  • Optum Certified Medical Assistant

    3 months ago

    West Orange, United States UnitedHealth Group Full time

    $3, Sign-on Bonus for External CandidatesOpportunities with Optum in the Tri-State region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and...

  • Assistant Medical Director

    4 weeks ago

    Orange, United States ConcertoCare Full time

    Job DescriptionJob DescriptionDescription:Are you a dynamic Physician-Provider looking to elevate your career to the next level of Leadership? We present to you a unique opportunity to blend top-tier clinical practice with leadership in our innovative healthcare organization, ConcertoCare. As the Assistant Medical Director, you will be at the forefront of...

  • Nursing Assistant

    1 month ago

    Orange, California, United States UCI Health Full time

    Who We AreUCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los...