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, CA2 days ago - ...plan to address all symptoms and update plans as needed. Collaborate with Medical Assistants to ensure timely completion of prior authorization requests, requests from attorneys, and requests from patients. Requirements: Amiable personality is a plus Attention to detail...SuggestedRelocation
National Brain Injury Institute PLLC
Sacramento, CA13 hours ago - Job Description Job Description Are you a motivated, goal-oriented professional looking to advance your career? The Don Lee Agency Farmers Insurance is seeking a dedicated Agent Trainee to help grow our client base, generate new business, and deliver tailored insurance...SuggestedTraineeship
Farmers Insurance Group
Torrance, CA29 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, 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, CA20 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, CA20 days ago- ...following to be hired: CA Property & Casualty License CA Life & Health License OR the ability to obtain at least one license prior to starting Must reside locally in or be willing to commute to Chico, California Excellent verbal and written communication...SuggestedHourly payLocal areaRemote workFlexible hours
Farmers Insurance - Paul Munly Agency
Chico, CA11 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, CA1 day 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, CA2 days 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, CA5 hours 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, CA7 days ago $150k - $170k
Job Description Job Description Reporting to the Director of Clinical Operations, the Nurse Manager, Prior Authorizations, provides clinical and operational leadership to the Prior Authorizations (PA) team within the Utilization Management (UM) function. You will manage...SuggestedWork at officeRemote workSan Francisco Health Plan
San Francisco, CA52 minutes agonew- ...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
Walnut Creek, CA9 days ago - ...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, CA4 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...SuggestedWork at office
Arya Medica Group Corporation
Mendota, CA21 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, CA7 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, CA8 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, CA16 days ago- ...Collaborate with healthcare providers to obtain necessary documentation and clinical information for insurance claims and prior authorization requests Coordinate with insurance companies to ensure timely and accurate processing of claims and prior authorization requests...
Noctrix Health
Pleasanton, CA7 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, CA8 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, CA5 hours 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, CA1 day 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, CA4 days ago$100k - $140k
...the company is transforming how providers manage their practices and deliver care. Role Overview The client is seeking a Prior Authorizations Lead to design, manage, and scale their prior authorization function. This role is ideal for an operator who excels at...Vivo HealthStaff
San Francisco, 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, CA5 hours ago $58.8k - $78.6k
...confidence. We are currently seeking a Supervisor, Order Entry and Authorizations to join our team in Carlsbad, C A. If you thrive in a dynamic... ...billing systems, verifying patient eligibility, obtaining prior authorizations , ensuring that claims are submitted correctly...Full timeWork experience placementVisa sponsorshipWork visaBreg, Inc.
Carlsbad, CA18 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...Full timeWork at officeLocal areaWorldwideNight shiftInizio Engage
El Monte, CA3 hours agonew$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, CA18 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, CA24 days ago $25 - $30 per hour
...Phlebotomy experience required (or certification). IV therapy and/or infusion training preferred. Understanding of prior authorizations and clinical workflows. Excellent communication skills and attention to detail. Ability to work efficiently in a fast-...Hourly payFull timeWork at officeMonday to FridayFlexible hoursWeekend workDay shiftWeekday workMonterey Pain & Spine Institute
Monterey, CA13 days ago
