Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Prior Authorization Specialist: Healthcare Claims & Compliance

UCLA Health

UCLA Health is seeking a health services professional to manage urgent, routine, pre-service, and retro authorization requests. You will process prior authorizations for claims adjudication using various business apps and ensure timely, accurate determinations per clinical protocols. The role requires strong communication, organizational and problem-solving skills, with the ability to work across departments. UCLA Health offers a stable environment in Southern California. #J-18808-Ljbffr UCLA Health

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Prior Authorization Specialist: Healthcare Claims & Compliance in Los Angeles, CA vacancy
  • $40 per hour

    Job Title: Intake Authorization Specialist Job Type: Full-time Pay: up to $40.00 per hour Expected Hours: 40 hours...  ...system. Adjudicate pharmacy benefit claims, including Medicare Part D. Qualifications Required: Prior experience in home infusion. Preferred: Familiarity... 
    Claims
    Hourly pay
    Full time
    Remote work

    The Misch Group

    Los Angeles, CA
    3 days ago
  •  ...information. Communicate with IPA regarding prescription claim or prior authorization status. Inventory management including placing orders,...  ...than 50 years, we've provided high-quality, low cost healthcare and preventative education for all. We are an Equal Opportunity... 
    Claims
    Local area

    To Help Everyone Health & Wellness Centers

    Los Angeles, CA
    5 days ago
  •  ...relationships with the healthcare provider network in a...  ...resources, referral, claim processing, portal access...  .... Resolves complex authorization or claims issues....  ...meet standards. Monitors compliance with CAP. Uses databases...  ...and experience; prior experience with physician... 
    Claims
    Contract work
    Work at office

    Priority Family Care Center

    Los Angeles, CA
    7 days ago
  • $33 - $36 per hour

     ...AmeriPharma is a rapidly growing healthcare company where you will have...  ...analytical Reimbursement Specialist III to join our dynamic team...  ...at submitting complex claims and appeals. If you are a proactive...  ...as needed. Ensures compliance with all payer rules, regulations... 
    Claims
    Hourly pay
    Monday to Friday

    AmeriPharma

    Beverly Hills, CA
    3 days ago
  • $205k - $375k

    Healthcare Regulatory Litigation Associate - 2-4 Years of ExperienceCalifornia (Los Angeles...  ...healthcare regulations and advise clients on compliance and riskParticipate in administrative...  ...appealsGovernment investigationsFalse Claims Act mattersFraud and abuse enforcementHealthcare... 
    Claims
    Remote work
    Flexible hours

    CyberCoders

    Los Angeles, CA
    3 days ago
  •  ...providers and stakeholders across eligibility, benefits, claims, and authorizations. You will ensure compassionate, accurate support across channels...  ...Medi-Cal and PASC programs, handling inquiries with HIPAA compliance, documenting interactions, and triaging requests to... 
    Claims

    L.A. Care

    Los Angeles, CA
    2 days ago
  • CHA Hollywood Presbyterian Medical Center seeks an Authorization Support professional to perform telephone and online authorizations for routine...  ...information, obtain approvals from payors, and resolve pended claims while ensuring patient data confidentiality. #J-18808-Ljbffr... 
    Claims

    CHA Hollywood Presbyterian Medical Center

    Los Angeles, CA
    3 days ago
  • AmeriPharma is seeking a highly skilled Reimbursement Specialist III in Beverly Hills, CA. You will play a key...  ...The ideal candidate has a deep understanding of healthcare billing and coding, and can handle complex claims and appeals with minimal supervision. #J-18808-Ljbffr... 
    Claims

    AmeriPharma

    Beverly Hills, CA
    3 days ago
  • $17 - $18.15 per hour

     ...We recognize that healthcare requires a human...  ...Access Associate Specialist plays a critical...  ...integrity, regulatory compliance, and a positive...  ..., and first-pass claim rates. Serves as...  ...patient accounts prior to patient visits...  ...reside and are authorized to work within the... 
    Claims
    Work at office
    Local area
    Remote work

    Ensemble Health Partners

    Los Angeles, CA
    4 days ago
  • $20 - $28 per hour

     ...our clients’ personal injury claims. The ideal candidate is experienced...  ...-paced legal environment. Prior experience in personal injury...  ...from hospitals, clinics, and healthcare providers Track and follow...  ...on file Maintain strict compliance with HIPAA and firm... 
    Claims
    Hourly pay
    Full time
    Work at office
    Immediate start
    Relocation
    Monday to Friday
    Shift work
    Afternoon shift
    Early shift

    YERUSHALMI LAW FIRM APC

    Beverly Hills, CA
    a month ago
  • $158.39k - $185.58k

     ...patients, caregivers, and healthcare providers in navigating insurance...  ..., educates stakeholders on prior authorization and billing processes, and...  ...access barriers and denied claims; escalate complex...  .../coding processes HIPAA compliance and healthcare regulatory knowledge... 
    Claims

    Amgen

    Los Angeles, CA
    13 days ago
  • $400k

     ...involving major civic, infrastructure, healthcare, energy, and commercial developments....  ...orders, payment issues, design-related claims, defaults, and project performance problems...  ...with procurement-related issues, contract compliance, and other project delivery concerns \n... 
    Claims
    Contract work
    For contractors
    Remote work

    We Are Legal Revolution

    Los Angeles, CA
    6 days ago
  • $18.92 - $23.46 per hour

    Recognized as a “Best Place to Work Modern Healthcare” - Join a team where people come first...  ...and accuracy, identify and audit claims, ensure all revenue opportunities are...  ...and medical third-party claims. Obtain prior authorizations; initiate requests, follow up to provide... 
    Claims
    Full time
    Contract work
    Temporary work
    Local area
    Immediate start
    Flexible hours

    Vital Care Infusion Services

    Glendale, CA
    1 day ago
  • $90k

     ...Medtronic is a global leader in healthcare technology with a Mission to...  ...Senior Stapling Robotics Specialist is a key technical and...  ...specific to each role.U.S. Work Authorization & SponsorshipAt Medtronic, we...  ...receive a suspicious message claiming to be from Medtronic, do not... 
    Claims
    H1b
    Work at office
    Local area
    Immediate start
    Remote work
    Flexible hours
    Shift work

    Medtronic plc

    Los Angeles, CA
    2 days ago
  • $47.84k

     ...Job Summary The Authorization Technician II supports...  ...Management (UM) Specialist by handling all...  ...and Weekly Compliance Reports. In addition...  ...requests using the claims and verify...  ...experience in UM/Prior Authorization. Skills...  ...Data Entry, Claims, Healthcare, Administrative,... 
    Claims
    Full time
    Work at office
    Weekend work

    L.A. Care

    Los Angeles, CA
    2 days ago
  • $121.06k

     ...Technology Strategy Lead - Claims, Finance, HR, Legal & Compliance Job Category:...  ...maintaining compliance with healthcare payer and regulatory requirements...  ...health, pharmacy, UM authorizations, quality oversight,...  ...operations enablement, Prior Authorization Interoperability... 
    Claims
    Full time

    L.A. Care Health Plan

    Los Angeles, CA
    1 day ago
  • A healthcare services provider near West Hollywood is seeking a Travel Health Information Services Technician. The role involves prioritizing customer requests, ensuring compliance with HIPAA regulations, and utilizing EPIC's Release of Information module effectively.... 
    Daily paid
    Full time
    Contract work
    Part time
    Shift work

    Bileddo Associates

    West Hollywood, CA
    11 hours ago
  • $76k - $199.6k

     ...involved in manufacturing, testing, or compliance, your contribution will directly impact...  ...Service and/or Account Management Relevant Healthcare/Scientific roles (e.g., RN, Pharmacist,...  .../or eligibility. Candidates must be authorized to be employed in the U.S. by any... 
    Permanent employment
    Full time
    H1b
    Local area
    Remote work
    Visa sponsorship
    Work visa
    Relocation package

    Pfizer

    Los Angeles, CA
    5 days ago
  •  .... (UAII) is seeking a Program Billing Specialist to oversee accurate billing, claims submission, and revenue cycle activities for its healthcare and community programs in Los Angeles....  ...payers to ensure timely reimbursement and compliance with applicable requirements. The role... 
    Claims

    United American Indian I Inc

    Los Angeles, CA
    2 days ago
  •  ...Description PURPOSE: The Prior Authorization Nurse will document and...  ...primary care physicians and specialists Documentation of denial...  ...California’s federally funded healthcare programs: Medi-Cal,...  ...management, care coordination, and claims processing services to... 
    Claims
    Contract work

    Preferred IPA of California

    Los Angeles, CA
    8 days ago
  • $111.6k - $139.4k

     ...developing, maintaining, and executing healthcare analytics and reporting solutions that...  ...intelligence tools.Analyze healthcare claims, EMR, and operational datasets to...  ...care management, utilization management, prior authorization, HCC risk adjustment, population health... 
    Claims
    Full time

    COPE Health Solutions

    Los Angeles, CA
    4 days ago
  • $31.51 - $62.64 per hour

    University of California - Los Angeles Health is seeking a Claims Quality Auditor to take on a vital role in a leading health organization...  ...will perform daily audits on claims, ensuring accuracy, compliance, and adherence to policies. Candidates must have a high school... 
    Claims
    Hourly pay

    University of California - Los Angeles Health

    Los Angeles, CA
    4 days ago
  •  ...Counsel About the Company Healthcare company seeking an interim in...  ...contracts, litigation, and claims, as well as labor and...  ...enterprise training on legal and compliance matters. Applicants for the Interim...  ...to practice law. While prior experience with the specific... 
    Claims
    Interim role

    Confidential

    Pasadena, CA
    1 day ago
  • COPE Health Solutions in New York or Los Angeles is seeking an Analyst, Healthcare Financial Analytics to join the finance team as a junior actuary embedded role. You will analyze claims and healthcare data across ACOs and Health Plans, delivering decision-ready insights... 
    Claims

    COPE Health Solutions

    Los Angeles, CA
    2 days ago
  •  ...patient relations (scheduling, complaints, communication), and compliance (OSHA, HIPAA) to ensure smooth practice flow, efficiency, and positive...  ...~ Financial Oversight:   Managing billing, insurance claims, collections, payroll, budgeting, and financial reporting.... 
    Claims

    MICHELLE TO DDS INC

    Los Angeles, CA
    15 days ago
  • Astrana Health in Monterey Park, CA is seeking a Lead - Claims Examiner to report to the Sr. Manager - Claims. This hybrid role combines...  ...improvements. You will mentor staff, monitor audits, drive compliance with CMS and coding standards (ICD-10, CPT, HCPCS), and coordinate... 
    Claims
    Work at office
    Work from home

    Astrana Health

    Monterey Park, CA
    11 hours ago
  • $130k - $190k

     ...Benefits include: ~ PPO Healthcare, vision, dental, life insurance...  ...transactions to ensure compliance with the Stark Law, Anti-Kickback Statute, False Claims Act, and state analogs, as well...  ...background checks with your authorization. Jobot will consider qualified... 
    Claims
    For contractors
    Local area

    Jobot

    Los Angeles, CA
    1 day ago
  •  ...Insurance Verification Specialist to join a growing U.S.-based healthcare practice.If you have...  ...completeness, and HIPAA compliance.What You'll DoVerify...  ...network coverageIdentify prior authorization requirementsDocument...  ...Weave experienceInsurance claims and follow-up... 
    Claims
    Immediate start

    Virtual Teammate

    Glendale, CA
    45 minutes ago
  • $400k

     ...involving major civic, infrastructure, healthcare, energy, and commercial developments....  ...orders, payment issues, design-related claims, defaults, and project performance problems...  ...with procurement-related issues, contract compliance, and other project delivery concerns... 
    Claims
    Contract work
    For contractors
    Remote work

    We Are Legal Revolution

    Los Angeles, CA
    4 days ago
  • Authorization Monitoring and Tracking Specialist job at Allcare Home Health. Glendale, CA. Position Summary: The Authorization...  ...-paced environment. Preferred: Prior experience as an Authorization...  ...Assistant in home health or healthcare setting. Familiarity with CMS and... 
    Work from home

    Comunidade Metodista

    Glendale, CA
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Prior Authorization Specialist: Healthcare Claims & Compliance. Be the first to apply!