Average salary: $83,663 /yearly
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- ...Coordinator 1 - 210120 Address: Various, CA, 99999 Job Description Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process. Perform review of pharmacy and override process in compliance with pharmaceutical related company and...SuggestedFull timeRemote work
A-Line Staffing Solutions
California City, CA1 day ago - ...abandoned due to: Cost barriers: Patients with high copays are 5x more likely to abandon treatment Insurance maze: Complex prior authorizations block access Logistical challenges: Coordinating medical visits for treatments Our solution: Neon's technology...SuggestedFull timeLive inNight shift
Neon Health
San Francisco, CA21 days ago $123.5k - $302.6k
...delivering high-quality, appropriate, and patient-centered care.\n What you’ll do: Provide clinical determinations for UM (prior authorizations, concurrent reviews, appeals, grievances, peer-to-peer). Partner with clinical and operational leaders to ensure high-...SuggestedFlexible hours1 day per weekUCLA Health
Los Angeles, CA19 days ago- ...tests with other health care providers, assessing pay source and authorizing payment under Medically Indigent Adult program as necessary. •... .... • Answer questions from providers regarding reimbursement, prior authorization and other documentation requirements. • Learns the...SuggestedWork at officeShift workNight shift
Integrated Healthcare Services
Bakersfield, CA6 days ago - ...abandoned due to: Cost barriers: Patients with high copays are 5x more likely to abandon treatment Insurance maze: Complex prior authorizations block access Logistical challenges: Coordinating medical visits for treatments Our solution: Neon's technology...SuggestedFull timeLive inNight shift
Neon Health
San Francisco, CA21 days ago $35k - $70k
...atrophy. Until now the only gold-standard proof was a $6,000–$8,000 PET scan involving radioactivity, long wait times, and prior authorizations most patients never get. - Our SaaS delivers monthly, in-office, radiation-free, PET-equivalent amyloid and tau imaging for...SuggestedContract workPrivate practiceWork at officeVistim Labs
San Diego, CA19 days ago$21 - $39 per hour
...description Room and vital patients Review histories, medications, allergies and HPI in the chart Return phone calls Get prior authorizations Schedule surgeries Call patients with results Review all staff and patient messages Answer phones Welcome...SuggestedHourly payWork at officeFlexible hoursDay shiftBASS MEDICAL GROUP
Ventura, CA20 days ago- ...text, generate auditable justifications for medical decisions, and reason over structured and unstructured data to automate the prior authorization process endtoend. Youll work on some of the most pressing problems in applied AIbalancing model expressiveness with...SuggestedFull timeWork at office
Latent
San Francisco, CA21 days ago $140k - $180k
...reports on the IPA side (UM supervisors + coordinator), and play a crucial role in providing operational leadership to the UM/Prior Authorization and Inpatient Teams (50 FTEs in total). Youll be responsible for CMS + Health Plan audits, and ensuring compliance with...SuggestedFull timeRemote workAmi Network
Pasadena, CA21 days ago- ...medical history, demographics, current condition, documentation. Verify insurance coverage, Medicare / Medicaid eligibility, prior authorizations as needed. Enter referral and patient data into EMR and maintain accurate documentation. Coordinate with clinical...SuggestedWork at office
Prudential Healthcare
Cerritos, CA17 hours ago - ...guidelines, and Centers for Medicare and Medicaid Services (CMS) standards. • Provides coordination and processing of pharmacy prior authorization requests and/or appeals. • Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any...SuggestedWork at officeShift work
Molina Healthcare
Long Beach, CA4 days ago - ...the physicians. ESSENTIAL DUTIES AND RESPONSIBILITIES Includes but not limited to the following: Perform prior authorizations for medications through various insurance portals Answer incoming phone calls for the Prescription Agent Queue Follow...SuggestedWork at officeVisa sponsorshipWork visaMonday to FridayShift work
Cypress Healthcare Partners
Salinas, CA1 day ago $211k - $260k
...abandoned due to: Cost barriers: Patients with high copays are 5x more likely to abandon treatment Insurance maze: Complex prior authorizations block access Logistical challenges: Coordinating medical visits for treatments Our solution: Neon's technology...SuggestedFull timeTemporary workLive inWork at officeNight shiftTensor | Phone Call Automation
San Francisco, CA21 days ago$125k - $150k
...dynamics across your territory—national, regional, and local insurance landscapes ~ Collaborate with Market Access, to overcome prior authorization barriers and ensure seamless patient onboarding ~ Drive formulary wins and in-office pull-through by equipping providers...SuggestedWork at officeLocal areaWorldwideNight shiftInizio Engage
La Crescenta, CA3 hours agonew- ...Prior Authorization Medical Director Physician Opportunity in the Los Angeles Area Please consider this unique opportunity to join a well-established and respected group of innovators in value-based care. This group of thought-leaders are in search of physician leaders...SuggestedLive inRemote workWork from homeRelocation package
Curative
Los Angeles, CA3 days ago - ...email addresses and telephone numbers, including their relationship to the candidate. References will not be contacted without prior authorization from the candidate. Application materials should be submitted in PDF format through the AGB Search portal using this link:...Full timeRelocation packageFlexible hours
New River Community College
Belmont, CA21 days ago $2,131.41 per month
...schedules. Ensure adherence to well-child visits, developmental screenings, and vaccination catch-up protocols. Coordinate prior authorizations for specialty referrals, medications, and diagnostic imaging. Maintain infection control practices, including isolation...Weekly payContract workWork at officeMonday to FridayShift workCAM Sonoma
Sonoma, CA3 days ago- ...Clinical Review Specialist I provides timely and accurate review and authorization of dental services based on eligibility and contract... ...provider participation and member eligibility Resolve claim and prior authorization that require UM Review Consistently meet...Contract workTemporary workWork experience placementLocal areaRemote work
Randstad
Fresno, CA4 days ago $123k - $180k
...structured referral processes, regular agency visits, and relationship-building activities. Make decisions within established authority levels and company guidelines, requesting exceptions when supported by data. Support workflow and account review processes as needed...Local areaMonday to FridayDay shiftUltimate Staffing
Los Angeles, CA7 days ago- ..., and critical incident identification, tracking, ad monitoring. This role will also decrease the Division of Medicine (DOM) prior authorization denial rate, which also removes access to care barriers and improves AHF patient outcomes. A RNCTM enhances the reputation...
AIDS Healthcare Foundation
Los Angeles, CA4 days ago - ...and 1 weekend per month. Patients per day is dependent on how busy the physician wants to be. Ultra sound in office. Billing, Prior Authorizations, MA's, Office Manager, front office, EMR, All provided in house! General OB/Gyn with interest in some high risk OB a plus....Permanent employmentWork at officeImmediate startRelocation packageWeekend work3 days per week1 day per week
Palm Health Resources
Grizzly Flats, CA17 hours ago - ...at check out. • Obtain Lab/test results from outside as well as sending standing orders to designated labs • Processing prior authorizations for various tests MD orders • Contacting insurance companies to file appeals or obtain verbal authorizations for urgent treatment...
BASS MEDICAL GROUP
Walnut Creek, CA8 days ago - ...Track lab results, call in prescriptions, and handle basic medical office duties Handle referrals to specialists and obtain prior authorizations from insurance companies. Coordinate with the front office team to manage patient flow and follow up on missed...Work at office
Arya Medica Group Corporation
Mendota, CA20 days ago - A national wholesale insurance brokerage firm is looking for an Underwriter/Broker in San Diego, CA. This entry-level, hybrid role combines marketing and underwriting to connect retail agents with insurance coverage solutions. The ideal candidate will possess a Bachelors...Full time
SeaCoast Underwriters, Inc. is now Risk Placement Services
San Diego, CA16 days ago - ...instruments ~ Knowledgeable in phlebotomy ~ Knowledgeable with medical terminology ~ Knowledgeable with insurances, referral, prior authorization ~ Knowledgeable with EMR scheduling systems ~ Assist with front and back office duties ~ Maintain a clean and organized...Work at office
Stein Dermatology APC
Escondido, CA6 days ago $140k - $155k
...Job Description The Director, Prior Authorization will be responsible for development of and maintenance of Prior Authorization and Denial Compliance Job Aids, Work Flows, procedures & related documents and ensuring alignment with HPN and regulatory Policies and guidance...Full timeCasual workRelocation packageFlexible hoursRegal Medical Group
Los Angeles County, CA17 days ago- ...prospective and retrospective review of the requests for service authorizations in order to monitor the continuity and coordination of care and to assist in the utilization of appropriate services. The Prior authorization Nurse conducts these reviews of authorization...Work at officeFlexible hours
Advanced Medical Management, Inc.
Long Beach, CA23 days ago - ...device Guide internal teams through the reimbursement process, providing support and education on insurance coverage and prior authorization process Collaborate with internal teams to obtain necessary documentation and clinical information for prior authorization...
Noctrix Health
Pleasanton, CA7 days ago $100k - $105k
...Job Description Job Description Position Summary: The Prior Authorization Supervisor (LVN) is responsible for supporting the process that manages all outpatient services, including Prior Authorization Lead Nurses and Review Nurses. The goal of the Clinical Supervisor...Full timeCasual workImmediate startRelocation packageFlexible hoursRegal Medical Group
Los Angeles, CA15 days ago- A leading insurance company is seeking an Executive Underwriter for Management Liability based in San Francisco, CA. This hybrid role involves administering underwriting rules, developing distributor relationships, and seeking growth opportunities. The ideal candidate ...Full time
Zurich Insurance
San Francisco, CA16 days ago
