Prior Authorization Specialist

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a dedicated Prior Authorization Specialist responsible for communicating with insurance providers to verify patient eligibility, managing prior authorization requests, and maintaining accurate documentation.

Key Responsibilities

• Communicates with insurance providers to verify patient eligibility, confirm coverage and benefits, and secure required prior authorizations.
• Manages and processes prior authorization requests submitted by clinics and Patient Care Coordinators.
• Accurately records and maintains detailed documentation of all findings and actions taken.
• Updates patient demographic information as needed to ensure accurate and complete billing statements.
• Consistently meets or exceeds established productivity and quality expectations for daily work output.
• Maintains accuracy levels in line with departmental error-rate standards.
• Provides training and guidance to internal staff on proper procedures for submitting, documenting, and processing prior authorization requests.

Qualifications

• 2+ years of recent prior authorization experience in a physician office or ASC setting.
• High school diploma or GED required.
• Preferred: Ophthalmology experience and a Medical Billing and Coding Diploma.

Skills

• Strong communication skills, both written and verbal.
• Attention to detail and strong organizational skills.
• Ability to work collaboratively within a team environment.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

Our client is an equal opportunity employer providing equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, or genetics.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).


Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

Any required state or Joint Commission training is compensated at the state or local minimum wage rate.

* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.