Healthcare Authorization Specialist - Referrals & Claims
jmh
JMH is hiring for an Authorization Specialist to process requests for full and shared risk plans. You will forward cases to Utilization Review, track determinations, and work with providers on retrospective authorizations. The role involves assisting providers and patients with process questions from provider and member services, while maintaining authorization activity statistics and reports. Per diem position in the United States, with Bay Area considerations. #J-18808-Ljbffr jmh
- John Muir Health is seeking an Authorization Specialist to process and track authorization requests for full risk and shared risk plans, coordinating... ...maintains statistics and reports on authorization activity, supporting efficient claims #J-18808-Ljbffr John Muir HealthClaims
$27.03 - $36.5 per hour
...operational functions to effectively process authorization requests for full risk and shared risk... ...not properly authorized at the time of claim receipt. Assists providers and patients... ...Health Maintenance Organization Referrals Required Certifications/Licensures Epic...ClaimsHourly payDaily paidWork at officeLocal areaShift work$27.03 - $36.5 per hour
...functions to effectively process authorization requests for full risk and... ...authorized at the time of claim receipt. Assists providers... ...Health Maintenance Organization Referrals Required Certifications/... ...the expertise of top cancer specialists from John Muir Health and UCSF...ClaimsHourly payDaily paidWork at officeLocal areaShift work- A mental health services provider in Pleasant Hill is seeking an experienced Field Representative to drive referrals from healthcare providers. This role involves educating referrers about our services and building relationships to enhance patient admissions. The ideal...Suggested
$28 - $35 per hour
...The Claims Resolution Specialist is responsible for the day-to-day investigation... ...-site, multi-specialty healthcare organization specializing... ...correspondence, medical records, authorizations, and supporting... ...information, authorizations, referrals, diagnosis coding,...ClaimsHourly payRemote workMonday to Friday- Avenue Healthcare is seeking a Reconciliation Officer to ensure accuracy and timely allocation of debtors’ receipts. The ideal candidate... ...Key responsibilities include reconciling remittances, preparing claims documentation, investigating variances, and maintaining relationships...Claims
- ...similarly trained and focused on appropriate cross-selling and referrals. -Ensure customer problems and complaints are handled professionally... ...(as assigned) Stop payments Holds Reg. E Claims Safe Deposit Box opening, closing and servicing (as assigned...ClaimsWork experience placementWork at office
$30.33 per hour
...wish to influence the quality of mental healthcare in your community? Do you have experience... ...training The Monitoring Investigations Specialist reports to the Program Director and is... ...and facility protocols to substantiate claims Draws conclusions based on the available...ClaimsHourly payFull timeRelocationMonday to FridayFlexible hoursShift work- SupportFinity™ in Walnut Creek is looking for an HMO/Medi-Cal Biller to assist with claim submissions and authorizations for healthcare services. This role entails keeping accurate records, engaging in follow-ups, and ensuring timely approvals for claims. Candidates must...ClaimsFull time
$75k - $165k
...is seeking an experienced Underwriting Specialist or Executive Underwriter, Construction PL... ...with Line of Business representatives on referrals and other business related needs, as... ...and 6 or more years of experience in the Claims or Underwriting Support area OR Zurich...ClaimsFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workVisa sponsorship$130k - $190k
...Why join us? Benefits include: PPO Healthcare, vision, dental, life insurance, and... ...Stark Law, Anti-Kickback Statute, False Claims Act, and state analogs, as well as licensing... ...to perform background checks with your authorization. Jobot will consider qualified...ClaimsFor contractorsLocal area- ...over 40 years in the industry. The AR Specialist drives the resolution of insurance... ...including monitoring and working assigned claim and AR worklists. Identify and resolve... ...reimbursement terms. Stay current on healthcare regulations, state-specific rules, and insurance...ClaimsContract workWork at office
$130k - $140k
...and Rehabilitation Center, a Generations Healthcare facility, is in search of Director of... ...activities of the department to ensure that claims are timely and/or appeals timely and in... ...building with the local hospitals and referral sites. Attends and participates in facility...ClaimsFull timeLocal areaMonday to FridayFlexible hours$117.5k - $222.99k
Individual(s) must be legally authorized to work in the United States without the need for... ...and Opportunity, MedInsight is one of the healthcare industry’s most trusted solutions for... ...knowledge of payer operations, healthcare data, claims analytics, and health plan workflows,...ClaimsFull timeWork experience placementRemote workFlexible hours$78.8k - $145.13k
Individual(s) must be legally authorized to work in the United States without the need for... ...and Opportunity, MedInsight is one of the healthcare industry’s most trusted solutions for... ...exposure to EHR systems, clinical data, and claims dataStrong communication skills (written...ClaimsFull timeWork experience placementRemote workFlexible hours$85.9k - $128.9k
...frequency of Workers’ Compensation claims with focus on use of the... ...relationships with external healthcare providers, insurance... ...Applicants must be currently authorized to work in the United States... ...Food and Beverage Services Referrals increase your chances of interviewing...ClaimsFull timeWork experience placementLocal areaWorldwide$207.96k - $252.78k
...General Liability, Property Insurance and Claims, Loss Control, Occupational Safety, and... ...involved supervisory and management authority and financial responsibility; public sector... ...extensive reference and background checks. Referrals increase your chances of interviewing at...ClaimsFull time- ...Job Description The Claims Resolution Specialist is responsible for the day... ...multi-site, multi-specialty healthcare organization specializing... ...correspondence, medical records, authorizations, and supporting... ...information, authorizations, referrals, diagnosis coding,...ClaimsRemote work
- ...Medical is seeking a DME Medical Billing Specialist to join our team. You will be... ...equipment services, ensuring accurate coding, claim submission, and follow-up to maximize reimbursement... ...verify insurance coverage, manage pre-authorizations, resolve denials, communicate with...Claims
$117.5k - $222.99k
Individual(s) must be legally authorized to work in the United States... ...retirement funding and healthcare financing, risk management and... ...actuaries to clinicians, technology specialists to plan administrators, we... ...organizations, healthcare claims, clinical and pharmacy data,...ClaimsHourly payFull timeTemporary workWork experience placementWork at officeRemote workWorldwideFlexible hours$165k - $195k
...mission to be the #1 automation company for healthcare administration. A successful candidate... .... Hands-on experience with core claims administration platforms. Demonstrated... ...HubSpot, Jira, or similar tooling. Work authorization in the United States. Work Environment...ClaimsContract workWork at officeWork from home$18 - $19 per hour
...and sanitation procedures. No certifications are required; GED or high school diploma preferred, with at least 1 year of experience. This healthcare role offers starting pay of $18-$19 per hour and a stable full-time schedule. #J-18808-Ljbffr Shadelands Post Acute inHourly payFull time- Senior Housing Specialist ABOUT US Founded in 1991, Hope Solutions, formerly Contra Costa... ...for data entry, note‑taking, and referral tracking. Providing shadowing opportunities... ...to support sponsorship. Only candidates authorized to work in the USA without the need for...Permanent employmentContract workWork at officeLocal areaTrial periodFlexible hoursNight shiftWeekend work
- Boomerang Healthcare’s Manager, Eligibility and Benefits role at Walnut Creek, CA is a senior administrative position overseeing eligibility... ...clinical specialties. You will standardize workflows, reduce claim denials, and ensure accurate patient liability is determined...ClaimsRemote job
$52.6k - $86.8k
...Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for... ...sound judgement and make effective decisions within established authority. Exceptional customer service skills and commitment to...ClaimsWork experience placementInternshipWork at office$22.94 per hour
...seeking a highly organized and experienced Healthcare Manager to join our team. As a... ...Verify insurance coverage and process claims- Ensure compliance with healthcare regulations... ...per hour Experience: Healthcare Authorization Rep: 2 years (Required) Medical billing...Hourly payContract workTemporary workWork at officeRelocation$70k - $100k
...Update skills and knowledge by attending conferences and seminars. • Show and explain orthopedic and prosthetic appliances to healthcare workers. • Maintenance of inventory of material in main and any satellite locations. Requirements: • Must be currently...Full timeImmediate start- ...Medical is looking for a DME Medical Billing Specialist to join our team. You will be... ...DME) services. Ensuring accurate coding, claim submission, and follow-up to maximize reimbursement... ...insurance coverage, managing pre-authorizations, and resolving denials....Claims
$97k - $189k
...resolution of the most complex and catastrophic workers' compensation claims. This individual contributor role provides company-wide... ...litigated workers' compensation claims. Serves as the technical authority on claim coverage, liability, compensability, exposure evaluation...ClaimsWork experience placementWork at office$117.45k - $195.75k
...interviews• Maintain quality control (integrity and excellence of completed project)• Support estimating staff (bid item specialist)• Avoid or mitigate claims and conflict• Complete all job close-out procedures• Conduct warranty follow-up (1-year warranty walks)• Complete...ClaimsFull timeContract workTemporary workFor subcontractorFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Healthcare Authorization Specialist - Referrals & Claims. Be the first to apply!
- configuration specialist Walnut Creek, CA
- localization specialist Walnut Creek, CA
- ecommerce specialist Walnut Creek, CA
- community health promotion specialist Walnut Creek, CA
- infectious disease specialist Walnut Creek, CA
- credit specialist Walnut Creek, CA
- microbiology specialist Walnut Creek, CA
- policy specialist Walnut Creek, CA
- mental health specialist Walnut Creek, CA
- restaurant specialist Walnut Creek, CA


