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Medical Authorization Specialist

1 month ago

Orange, California, United States The Midtown Group Full time
Job Summary

We are seeking a highly motivated and experienced Medical Authorization Assistant to join our team at The Midtown Group. As a Medical Authorization Assistant, you will play a critical role in providing office and referral management services, serving as a contact between members, physicians, providers, and staff.

Key Responsibilities
  • Process initial intake of information, assist with authorization functions, and gather information.
  • Review and process requests for authorization and notification of medical services from health professionals, clinical facilities, and ancillary providers.
  • Monitor tasks related to prior authorization and referral processes.
  • Apply the network's medical criteria and policies/procedures to authorization or referral requests from medical professionals, clinical facilities, and ancillary providers.
  • Interact with provider callers, acting as a resource for their needs.
Requirements
  • High School diploma or equivalent required.
  • 2 years of experience in a healthcare or managed care setting required.
  • Bilingual in English and one of the defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese) preferred.
  • Prior authorization and utilization management process experience preferred.
Working Conditions

This position is eligible for telework in Southern California. The schedule will be Thursday-Monday with Tuesday/Wednesday off.

The Midtown Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.