Prior Authorization Coordinator

2 months ago


Northridge, California, United States Regal Medical Group Full time
Job Summary

We are seeking a highly organized and detail-oriented Prior Authorization Coordinator to join our team at Regal Medical Group. As a Prior Authorization Coordinator, you will play a critical role in facilitating the referral process and ensuring that patients receive the right care at the right time.

Key Responsibilities
  • Process requests from Access Express that are pended or reprocess approved or denied authorizations and package properly for review and resolution.
  • Check eligibility and benefits on all DME and home health authorizations prior to forwarding on request to prior authorization nurse or medical director for approval.
  • Capture any leakage and provide feedback to the leadership team for additional training.
  • Maintain turnaround time compliance in all aspects of the Prior Authorization process.
  • Work in collaboration with the department Prior Auth Assistants, Specialists, Team Leads, Supervisor, Managers and Regional Medical Directors and Network Managers to ensure a level of referral processing that meets or exceeds the organization's expectation.
Requirements
  • High School graduate required; Associates in Arts degree preferred.
  • Ability to operate PC based software programs or data base management systems.
  • Knowledge of computers, faxes, printers and all other equipment.
  • Proficient in MS Office programs (i.e. Word, Excel, Outlook, Access and PowerPoint).
  • 1-2 years IPA or Medical office experience.
  • Experience with prior authorization process strongly preferred.
  • Knowledge of Healthcare and Managed Care preferred.
  • Typing 60 words per minute with accuracy.
  • Must possess strong organizational skills and be detail oriented.
  • Ability to multi-task and meet turnaround times.
  • Proficient with turnaround time compliance in all aspects of the PA Process.
  • Ability to deal with responsibility with confidential matters.
  • Ability to work in a multi-task, high energy environment.
Benefits

We offer a comprehensive benefits package, including health and wellness benefits, savings and retirement plans, and other perks. Our team is dedicated to providing a supportive and collaborative work environment that allows our employees to thrive and grow in their careers.

Regal Medical Group is an equal opportunity employer and welcomes applications from qualified candidates who share our commitment to excellence and patient care.



  • Northridge, California, United States Regal Medical Group Full time

    Job Title: Prior Authorization CoordinatorRegal Medical Group is seeking a highly skilled Prior Authorization Coordinator to join our team. As a Prior Authorization Coordinator, you will play a critical role in facilitating the referral process and ensuring that patients receive the necessary medical care in a timely and efficient manner.Key...


  • Northridge, California, United States Regal Medical Group Full time

    Job SummaryWe are seeking an experienced Prior Authorization Coordinator Team Lead to join our team at Regal Medical Group. This role requires a subject matter expert in the prior authorization process, responsible for providing guidance and support to prior authorization staff.Key ResponsibilitiesAssist with monitoring of prior auth process to ensure...


  • Northridge, California, United States Regal Medical Group Full time

    Job Title: Authorization SpecialistRegal Medical Group is seeking a highly skilled Authorization Specialist to join our team. As a key member of our clinical operations team, you will be responsible for ensuring seamless authorization processes for our patients.Key Responsibilities:Serve as the primary point of contact for inpatient inquiries, providing...


  • Northridge, California, United States Regal Medical Group Full time

    Job Title: Authorization SpecialistRegal Medical Group is seeking a highly skilled Authorization Specialist to join our team. As a key member of our clinical operations team, you will be responsible for ensuring seamless authorization processes for our patients.Key Responsibilities:Serve as the primary point of contact for inpatient inquiries, providing...


  • Northridge, California, United States ACT Medical Group Full time

    Patient Care Navigator Job DescriptionAs a Patient Care Navigator at ACT Medical Group, you will coordinate hospice services for managed care patients, ensuring a seamless transition to hospice care. Your responsibilities will include collaborating with inpatient utilization review departments and managed care organizations to facilitate safe, early...


  • Northridge, California, United States Regal Medical Group Full time

    Job Title: Outpatient Care CoordinatorRegal Medical Group is seeking a highly skilled and dedicated Outpatient Care Coordinator to join our team. As a key member of our healthcare team, you will play a vital role in ensuring the seamless coordination of care for our high-risk patients.Key Responsibilities:Assist Outpatient Case Managers in arranging services...


  • Northridge, California, United States ACT Medical Group Full time

    About the RoleWe are seeking a highly skilled and compassionate Hospice Service Coordinator to join our team at ACT Medical Group. As a key member of our care team, you will play a vital role in coordinating hospice services for managed care patients, ensuring seamless transitions and delivering exceptional patient care.Key ResponsibilitiesCoordinate Hospice...


  • Northridge, California, United States Regal Medical Group Full time

    Job Title: Utilization Review SpecialistAt Regal Medical Group, we are seeking a highly skilled Utilization Review Specialist to join our team. As a Utilization Review Specialist, you will play a critical role in promoting the quality and cost-effectiveness of medical care by applying clinical acumen and policies to prior authorization specialty referral...


  • Northridge, California, United States Regal Medical Group Full time

    Job SummaryThe Clinical Utilization Review Specialist will play a critical role in promoting quality and cost-effective medical care by applying clinical acumen and policies to prior authorization specialty referral requests. This position requires a strong understanding of healthcare and managed care principles, as well as excellent communication and...

  • RN Care Coordinator

    2 weeks ago


    Northridge, California, United States Unavailable Full time

    Job SummaryUnavailable is seeking a skilled RN Care Coordinator to join our team. As a key member of our healthcare team, you will be responsible for overseeing the progression of care and discharge planning for identified patients requiring these services.The ideal candidate will have a strong background in nursing and experience in care coordination, with...


  • Northridge, California, United States ACT Medical Group Full time

    {"Job Title": "Assistant Case Manager", "Job Description": "About the RoleWe are seeking a skilled and compassionate Assistant Case Manager to join our team at ACT Medical Group. As a key member of our hospice care team, you will play a vital role in coordinating services for managed care patients, ensuring seamless transitions, and promoting maximum...

  • RN Care Coordinator

    3 weeks ago


    Northridge, California, United States Dignity Health Full time

    Job Title: RN Care CoordinatorWe are seeking a skilled RN Care Coordinator to join our team at Dignity Health – Northridge Hospital Medical Center. As a key member of our healthcare team, you will be responsible for overseeing the progression of care and discharge planning for identified patients requiring these services.Key Responsibilities:Completes and...

  • RN Care Coordinator

    4 weeks ago


    Northridge, California, United States Dignity Health Full time

    Job Title: RN Care CoordinatorAt Dignity Health, we are seeking a skilled RN Care Coordinator to join our team. As a RN Care Coordinator, you will play a critical role in overseeing the progression of care and discharge planning for identified patients requiring these services.Responsibilities:Completes and documents a discharge planning assessment on those...

  • RN Care Coordinator

    3 weeks ago


    Northridge, California, United States Dignity Health Full time

    Job DescriptionJob Title: RN Care CoordinatorJob Summary:We are seeking a skilled RN Care Coordinator to join our team at Dignity Health – Northridge Hospital Medical Center. As a RN Care Coordinator, you will be responsible for overseeing the progression of care and discharge planning for identified patients requiring these services.Key...


  • Northridge, California, United States Regal Medical Group Full time

    Job Title: Population Health CoordinatorRegal Medical Group is seeking a highly skilled and motivated Population Health Coordinator to join our team. As a key member of our Population Health department, you will play a critical role in supporting the Director of Population Health in managing high-level management projects, coordinating scheduling, and...

  • RN Care Coordinator

    3 weeks ago


    Northridge, California, United States Unavailable Full time

    Job SummaryDignity Health – Northridge Hospital Medical Center is seeking a skilled RN Care Coordinator to oversee the progression of care and discharge planning for identified patients. The ideal candidate will have a strong background in acute hospital clinical experience and a passion for delivering high-quality patient care.This role requires a...

  • RN Care Coordinator

    3 weeks ago


    Northridge, California, United States CommonSpirit Health Full time

    Job Title: RN Care CoordinatorJoin our team of dedicated healthcare professionals at CommonSpirit Health, a leading provider of compassionate, high-quality, and affordable patient-centered care. We are seeking a skilled RN Care Coordinator to oversee the progression of care and discharge planning for identified patients requiring these...


  • Northridge, California, United States Optum Full time

    Job SummaryWe are seeking a highly skilled and detail-oriented Per Diem Associate Patient Care Coordinator to join our team at Optum. As a key member of our front office team, you will be responsible for providing exceptional patient care and administrative support to our patients and healthcare providers.Key ResponsibilitiesGreets patients and manages wait...


  • Northridge, California, United States PDS Health Full time

    PDS Health Job DescriptionJob Title: Dental Office CoordinatorJob Summary: We are seeking a highly organized and detail-oriented Dental Office Coordinator to join our team at PDS Health. As a key member of our front office staff, you will be responsible for providing exceptional patient care and ensuring a smooth and efficient experience for our...


  • Northridge, California, United States Unavailable Full time

    Job Title: RN Case Manager Care CoordinatorAt Dignity Health – Northridge Hospital Medical Center, we are seeking a skilled RN Case Manager Care Coordinator to join our team. As a key member of our healthcare team, you will be responsible for overseeing the progression of care and discharge planning for identified patients requiring these services.The...