Eligibility and Authorization Specialist
3 weeks ago
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. Typical duties include contacting payers to request service authorization and collecting financial and/or demographic information from patients.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 experience1 year of experience with medical terminology and healthcare insurance processes, home health preferredExcellent communication and customer service skillsProficiency in the use of healthcare information systemsAbility to prioritize and multitaskAbility to maintain professional tone at all times when communicating with patients and payer representativesCritical problem solving skillsExperience within financial clearance settingStrong attention to detailExperience with MS Office Suite, including Word, Excel, PowerPoint, Outlook, and Teams#J-18808-Ljbffr
by Jobble
-
Authorization Specialist
6 days ago
Los Angeles, United States A-Line Staffing Solutions Full timeJob DescriptionJob DescriptionA-Line Staffing is now hiring an Remote Authorization Specialist. The Authorization Specialist would be working for a major company and has career growth potential This would be full time / 40+ hours per weekIf you are interested in this Authorization Specialist position, please contact Mitch at...
-
Eligibility and Authorization Specialist
1 month ago
Los Angeles, United States Choice Health Group Full time**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 s and Medical terminology. - Reviews physician orders for medical necessity and...
-
Eligibility and Authorization Specialist
1 month ago
Los Angeles, United States Choice Health Group Full timeJob Description Job Description Salary: $20-$24 DOE 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 s and Medical terminology. Reviews...
-
Eligibility and Authorization Specialist
1 month ago
Los Angeles, United States Regroup Full timeResponsibilities 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 s and Medical terminology. Reviews physician orders for medical necessity and accuracy and...
-
Eligibility and Authorization Specialist
2 days ago
Los Angeles, United States Regroup Full timeResponsibilities 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 s and Medical terminology. Reviews physician orders for medical necessity and accuracy and...
-
Eligibility and Authorization Specialist
1 month ago
Los Angeles, United States Choice Health Group Full timeJob DescriptionJob DescriptionSalary: $20-$24 DOEResponsibilitiesThis 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 s and Medical terminology.Reviews physician...
-
Eligibility and Authorization Specialist
2 days ago
Los Angeles, United States Choice Health Group Full timeJob DescriptionJob DescriptionSalary: $20-$24 DOEResponsibilitiesThis 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 s and Medical terminology.Reviews physician...
-
Eligibility & Authorization Specialist
1 week ago
Los Angeles, United States Choice Health Group Full timeThe Doctor’s Choice is a licensed Home Health Services agency that provides a full range of in-home medical, rehabilitative, custodial, and companionship services to individuals and families throughout Los Angeles County. Whether you or a loved one is in need of medical care, housekeeping, physical therapy, or companionship, we are here to help. Our staff...
-
Eligibility and Authorization Specialist
3 weeks ago
Los Angeles, United States Regroup Full timeResponsibilitiesThis 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 s and Medical terminology.Reviews physician orders for medical necessity and accuracy and...
-
Prior Authorization Specialist
6 days ago
Los Angeles, United States A-Line Staffing Solutions Full timeJob DescriptionJob DescriptionA-Line Staffing is now hiring a remote Prior Authorization Specialist with a major health plan company. This would be full time / 40+ hours per week.Prior Authorization Specialist CompensationThe pay for this position is $23 per hourBenefits are available to full-time employees after 90 days of employmentA 401(k) with a company...
-
Childcare Eligibility Specialist
1 week ago
Los Angeles, United States Crystal Stairs Full timeJob DescriptionJob DescriptionCrystal Stairs, Inc. Improving the Lives of Families throughChild Care Services, Research, and AdvocacyCrystal Stairs is committed to building and sustaining a diverse, fully vaccinated workforce and culture. As part of this commitment, Crystal Stairs does not and shall not discriminate on the basis of race, color, religion...
-
Childcare Eligibility Specialist
2 days ago
Los Angeles, United States Crystal Stairs Full timeJob DescriptionJob DescriptionCrystal Stairs, Inc. Improving the Lives of Families throughChild Care Services, Research, and AdvocacyCrystal Stairs is committed to building and sustaining a diverse, fully vaccinated workforce and culture. As part of this commitment, Crystal Stairs does not and shall not discriminate on the basis of race, color, religion...
-
Clinical Authorization Specialist
1 month ago
Los Angeles, United States Keck Medical Center of USC 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 service line. The Specialist will be instrumental in obtaining written...
-
Childcare Eligibility Specialist
2 weeks ago
Los Angeles, United States Crystal Stairs Full timeCrystal Stairs, Inc. Improving the Lives of Families throughChild Care Services, Research, and AdvocacyCrystal Stairs is committed to building and sustaining a diverse, fully vaccinated workforce and culture. As part of this commitment, Crystal Stairs does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender...
-
Childcare Eligibility Specialist
2 days ago
Los Angeles, United States Crystal Stairs Full timeCrystal Stairs, Inc. Improving the Lives of Families throughChild Care Services, Research, and AdvocacyCrystal Stairs is committed to building and sustaining a diverse, fully vaccinated workforce and culture. As part of this commitment, Crystal Stairs does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender...
-
Family Services Eligibility Specialist
1 week ago
Los Angeles, United States Crystal Stairs Full timeJob DescriptionJob DescriptionCrystal Stairs, Inc. Improving the Lives of Families throughChild Care Services, Research, and AdvocacyCrystal Stairs is committed to building and sustaining a diverse, fully vaccinated workforce and culture. As part of this commitment, Crystal Stairs does not and shall not discriminate on the basis of race, color, religion...
-
Family Services Eligibility Specialist
2 days ago
Los Angeles, United States Crystal Stairs Full timeJob DescriptionJob DescriptionCrystal Stairs, Inc. Improving the Lives of Families throughChild Care Services, Research, and AdvocacyCrystal Stairs is committed to building and sustaining a diverse, fully vaccinated workforce and culture. As part of this commitment, Crystal Stairs does not and shall not discriminate on the basis of race, color, religion...
-
Authorization Technician II
2 weeks ago
Los Angeles, United States L.A. Care Health Plan Full timeAuthorization Technician II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11131 Salary Range: $47,840.00 (Min.) - $57,062.00 (Mid.) - $68,474.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California...
-
Authorization Technician II
2 months ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $47, Min.) - $57, Mid.) - $68, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Authorization Technician II
2 days ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $47, Min.) - $57, Mid.) - $68, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...