Prior Authorization Coordinator

2 weeks ago


Northridge, California, United States Regal Medical Group Full time
Job Title: Prior Authorization Coordinator

Regal 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 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.
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.
Benefits:

Regal Medical Group offers a comprehensive benefits package, including employer-paid comprehensive medical, pharmacy, and dental for employees, vision insurance, zero co-payments for employed physician office visits, flexible spending account, employer-paid life insurance, employee assistance program, behavioral health services, 401k retirement savings plan, income protection insurance, vacation time, company celebrations, employee assistance program, employee referral bonus, tuition reimbursement, license renewal CEU cost reimbursement program, business-casual working environment, sick days, paid holidays, and mileage.

Regal Medical Group is an equal opportunity employer and welcomes applications from qualified candidates with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.



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