Clinical Review Nurse — Prior Authorization Specialist
Akido
Akido is seeking a Clinical Review Nurse - Prior Authorization to join our team in California. The role involves reviewing and processing prior authorization requests to ensure compliance with health plan and regulatory requirements. You'll work closely with medical providers and operational teams to facilitate timely and accurate authorization determinations. The ideal candidate will possess an active California LVN or RN license and have at least 3-5 years of clinical utilization management review experience. Experience with EZCap is preferred. This role directly impacts our mission to enhance the quality of healthcare. #J-18808-Ljbffr Akido
$62.4k - $93.6k
Clinical Review Nurse - Prior Authorization The Clinical Review Nurse - Prior Authorization is responsible for reviewing and processing prior authorization requests to ensure medical necessity, appropriate level of care, and compliance with health plan and regulatory requirements...Suggested$62.4k - $93.6k
Akido Labs, Inc. in Chino, California, is looking for a Clinical Review Nurse - Prior Authorization to review and process prior authorization requests. This role interacts with providers and operational teams to ensure compliance and timely determinations based on clinical...Suggested- Akido Labs is looking for a Clinical Review Nurse in California to manage prior authorization requests. This role ensures compliance with clinical guidelines and coordinates closely with healthcare providers. The ideal candidate will possess an active California LVN or...Suggested
- ...with us.JOB SUMMARY:The Adjudication Specialist manages a portfolio of rejected pharmacy... ...:Manage and Identify Claims Portfolio:Review and evaluate insurance claims to... ...necessary payer paperwork, including prior authorization forms and manual billing.Handle non-standard...SuggestedFull timePart timeSeasonal workShift work
- An established industry player in health care is seeking a Utilization Review Nurse to join their dedicated team. In this vital role, you will evaluate medical records and apply clinical expertise to ensure the delivery of necessary health services. Your contributions will...Suggested
- Join the Clean Energy RevolutionBecome an Invoicing Senior Specialist at Southern California Edison (SCE) and build a better tomorrow. This... ...such as FATS, EMST, and Click Mobile, you will support the review of service orders and provide guidance on non-standard, high-impact...Work at officeRemote workRelocation
$105k - $110k
Hill International is seeking a Cost Specialist in Pomona, CaliforniaHill International, with more than 4,300+ professionals in over 100... ...prepare forecast reports. (approximately 1200+ records)Prepare/review /update project budgets/baselines, short- and long-term forecasts...Temporary workLocal areaWorldwideFlexible hours- ...Tuesdays OR Thursdays Duration: 05/19/2026 to 11/18/2027 Description Job duties may include: lead team members in the preparation and review of regulatory reporting packages quarterly and annually in accordance with the requirements of regulatory bodies; implement sound...2 days per week
- ...Yard Specialist At Clark Pacific, the Yard Specialist supports daily manufacturing operations across multiple functional areas while... ...pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor....Full timeShift work
$23 per hour
...Position Purpose The Asset Protection Specialist is primarily responsible for preventing financial loss caused by theft and fraud and... ...but not limited to identifying incidents of theft and fraud, reviewing CCTV and exception reports, monitoring the store's physical security...Local area- ...Position Purpose: The Asset Protection Specialist is primarily responsible for preventing financial loss caused by theft and fraud and... ...but not limited to identifying incidents of theft and fraud, reviewing CCTV and exception reports, monitoring the store's physical security...
$70.3k - $99.59k
...to join our corporate team! Responsibilities The Compensation Specialist will analyze market trends, conduct salary surveys, and ensure... ...years preferred in data analysis, job description development and review. Pay Transparency Prime Healthcare offers competitive...Daily paidFull timeTemporary workPart timeLocal areaShift work- Position: Nursing Faculty Member Responsibilities... ...working with students in a clinical setting you will:... ...midterm/end of semester reviews. Experience Working... ...Minimum two (2) years of prior experience as a... ...regulations of state authorization agencies. Master’s degree...Full timeLocal areaImmediate startNight shift
- ...Vendor Payment Specialist San Gabriel/Pomona Regional Center (SG/PRC) is a private, nonprofit... .... Essential Job Functions Review and reconcile invoices for payment, ensuring... ...and checks. Code and input purchase authorizations into the system. Manage the emailing...Work at office
- ...Provides high level member service. Job Duties: Schedules, develops, counsels, trains, and directs department personnel. Reviews and approves area timecards. Drafts and participates in presentation of employee performance appraisals. Oversees apprentices...Full timeTemporary workApprenticeshipWork at office
- Senior Compensation & Classification Specialist Job no: 560201 Work type: Staff Location: Pomona Categories: Confidential, Probationary... ...reclassification, in-range progression, and equity-adjustment reviews across multiple bargaining units, resolving escalated or...Full timeContract workFor contractorsWork experience placementWork at officeRemote work
- ...the Clean Energy Revolution Become a Rights Analysis, Senior Specialist at Southern California Edison (SCE) and build a better tomorrow... ...and perform Rights Studies for Major Projects Organization. · Review legal descriptions and associated documents in support of SCE’s...Remote workRelocation
- ...Branch Specialist This role involves providing exceptional member service in a high-volume, schedule-driven environment with a strong... ...credit cards. Protect and verify the identity of members and review account information for alerts and irregularities. Act and respond...Local areaMonday to FridayShift work
- Southern California Edison is seeking a Final Inspection Senior Specialist in California to support Meter Operations. You will apply... ...You will work with tools such as FATS, EMST, and Click Mobile to review orders and deliver actionable insights, while coordinating with...
$73k - $84k
...have an excellent opportunity for a full-time Production Safety Specialist based in our Chino, California production facility. The Safety... ...and conduction of routine annual safety observations/reviews of production programs to ensure equipment and infrastructure...Full timeWork at officeNight shiftWeekend work- Position Title Disability Specialist Position Control Number S04107 Type of Position... ..., social work, or a related field. Prior experience reviewing, evaluating, and determining... ...general direction of the Director, authorizes accommodations for students with disabilities...Hourly payPermanent employmentFull timeTemporary workWork at officeLocal areaRemote workMonday to Friday
$21.05 per hour
...the direction of the Associate Registrar, the Academic Records Specialist I provides front‑line services for the Office of the Registrar... ...judgment to determine appropriate solutions. Responsible for reviewing and maintaining the Office of the Registrar email inbox and...Hourly payWork at officeLocal areaMonday to FridayAfternoon shift- ...an immediate opening for a Patient Account Representative in Pomona, CA. This is a 13-month contract onsite with benefits. You will review AR aging, follow up on hospital claims, and manage UB-04 facility claims to maximize reimbursements. Requirements include 1-3 years...Contract workImmediate start
- Spectraforce Technologies seeks a Technical Specialist/Scientist 3 with a focus on wetlands and waterway permitting. The role centers on technical reviews, coordination with consultants, and managing permit documentation for state and federal agencies. Ideal candidates...Remote job
- ...the Clean Energy Revolution Become an Final Inspection Senior Specialist at Southern California Edison (SCE) and build a better tomorrow... ...tools such as FATS, EMST, and Click Mobile, you will support the review of service orders and provide guidance on non-standard, high-...Work at officeRemote workRelocation
$105k - $110k
Job Description Hill International is seeking a Cost Specialist in Pomona, California. Responsibilities Download financial data from various... ...forecast reports. (approximately 1200+ records) Prepare/review/update project budgets/baselines, short- and long-term forecasts...Temporary workLocal areaFlexible hours- San Gabriel/Pomona Regional Center in Pomona, CA seeks a Vendor Payment Specialist to process accounts payable efficiently and accurately. You will review invoices, ensure documentation integrity, and support electronic payments while adhering to internal controls and...Work at office
- Southern California Edison seeks an Invoicing Senior Specialist to partner with Senior Metering Specialists, Advisors, Engineers and Project... .... The role uses tools like FATS, EMST, and Click Mobile to review orders and guide non-standard metering scenarios with autonomy....
- Western University of Health Sciences in Pomona, CA, seeks a Disability Specialist to work with students requesting accommodations through an interactive process, reviewing medical and educational documents to determine appropriate academic adjustments under ADA, ADAAA...
- ...requirements. Manage system integrations with other enterprise systems and ensure continuity of Maximo services. Document and review business processes, procedures, roles, and responsibilities using BPMN standards. Support the development of the Enterprise...Contract work3 days per week
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