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 $22 per hour
...Job Description Job Summary We are seeking a detail-oriented Prior Authorization / Insurance Verification Specialist to join our team. The ideal candidate will be responsible for obtaining insurance authorizations and checking eligibility for medical procedures...SuggestedHourly payFull timeWork at officeApex Practice Management Group
Los Angeles, CA2 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 - ...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...Suggested
BASS Medical Group
Brentwood, CA3 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$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 County, 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 $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$100 - $120 per hour
...200~300 patients monthly) Admin Suppor t: Klarity care team will assist practitioners closely on scheduling, billing, prior authorizations, and insurance. Flexible hours : Klarity allows practitioners to see patients on their own schedule with no operation hour...SuggestedPart timeFor contractorsRemote workFlexible hoursKlarity Health
Santa Monica, CA4 days ago$124k - $154k
...healthcare organization in California is seeking a Manager of Authorization to oversee member utilization management. The role involves providing... ...ensure compliance with medical management policies, managing prior authorization requests, and optimizing department operations....SuggestedHill Physicians Medical Group
Sacramento, CA14 hours ago- ...Job Description The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. Representative...Suggested
Hire Talent
Bakersfield, CA3 days ago - ...Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. Processes requests within required timelines. Refers appropriate cases to Medical...SuggestedWork at officeMonday to FridayWeekend work
Molina Healthcare
Long Beach, CA3 days ago $151.97k - $200.43k
...A leading medical institution in San Diego is seeking a Prior Authorization UM Case Manager. The role is hybrid, requiring an RN license from California and a minimum of two years of experience in prior authorization or utilization management. Responsibilities include...University of California
San Diego, CA1 day ago- ...A leading healthcare organization in San Diego seeks a Prior Authorization UM Case Manager to oversee the authorization process. You will ensure that requests meet criteria and coordinate with healthcare providers and insurers. Ideal candidates have an RN license, 2+ years...1 day per week
UC San Diego Health
San Diego, CA3 days ago - ...A prestigious academic healthcare institution is seeking a Prior Authorization UM Case Manager who will manage the prior authorization process for medical services and medications. This role requires a graduate of an accredited nursing program with an RN license in California...Remote work
University of California San Diego
San Diego, CA2 days ago - ...Pharmacist Position Our client is looking for multiple Pharmacists with prior authorization experience. This is a remote position so you must have a secure and quiet place to work without interruptions. Responsibilities include evaluating and reviewing all prior authorization...Remote work
ICONMA
Murrieta, CA14 hours 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...Work at office
Prudential Healthcare
Cerritos, CA14 hours ago $24 - $26 per hour
...responsibilities, including inputting templates and chart notes as directed by physicians. Process prescription refills and manage prior authorizations. Log pathology samples and coordinate with appropriate laboratories. Operate specialized equipment such as Narrowband...Hourly payLocal areaMonday to FridayPhyNet Dermatology LLC (External)
Redondo Beach, CA4 days ago- ...Update patients' information and accurately enter it in EMA. Identify payer sources, verify insurance eligibility, and verify prior authorization. Record and collect patient copays and/or balances at check?in/checkout. Perform other duties as assigned....Temporary workWork at office
West Dermatology
Anaheim, CA4 days ago - ...Degree License to practice in California must be in progress prior to the start date Five years experience as a practicing... ...physician with knowledge of managed care and the process for prior authorization review Knowledge of physician social and political behavior...Full time
Vivo HealthStaff
San Diego, CA2 days ago $21.16 - $28.82 per hour
...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...Hourly payWork experience placementWork at officeMolina Healthcare
San Francisco, CA3 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...Work at officeVisa sponsorshipWork visaMonday to FridayShift work
Cypress Healthcare Partners
Salinas, CA1 day ago - ...Prior Authorization Pharmacist Location: Remote The main focus of this position is to ensure that all prior authorizations are processed efficiently and accurately. This role requires a deep understanding of insurance policies and the ability to navigate complex...Remote work
US Tech Solutions
Los Angeles, CA2 days ago - ...and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare... ...and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for...Full timeRemote workWorldwide
University of Miami
Bakersfield, 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...Full 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...Work at officeLocal areaWorldwideNight shiftInizio Engage
Los Angeles, CA48 minutes 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...Live inRemote workWork from homeRelocation package
Curative
Los Angeles, CA3 days ago
