Medical Authorization Assistant
2 months ago
**Client: CalOptima Health**
**Job Title: Medical Authorization Assistant**
**Duration: 06 Months**
**Start Date: ASAP**
**Location: 505 City Parkway West, CA**
**Position Type: Contract**
**Interview Type: In Person/Web Interview**
**Ceipal ID: CAL_HD416_BT**
**Description**:
**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 CalOptima Health members and providers to complete referral information.
- Authorizes requested services according to CalOptima Health’s authorization guidelines, performing data entry into the authorization system and verifying eligibility.
- Contacts the health networks and CalOptima Health 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% - Other
- 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 CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese)
- Prior authorization and utilization management process experience.
**Knowledge & Abilities**:
- Develop rapport and establish and maintain effective working relationships with CalOptima Health's 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.
**Job Types**: Part-time, Contract
Pay: $20.10 - $24.21 per hour
**Experience**:
- Insurance verification: 4 years (preferred)
- Medical billing: 4 years (preferred)
- Healthcare: 4 years (required)
Ability to Commute:
- Orange, CA 92868 (required)
Work Location: In person
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