Average salary: $83,663 /yearly
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$111.4k - $132.5k
...under limited technical direction and within broad limits and authority, adjudicate moderately complex commercial general liability bodily... ...: Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited...SuggestedLocal areaArgo Group
Los Angeles, CA5 days ago$22 per hour
...calculate deductibles and co-pays. Verify benefits, prepares pre-authorization requests. Document approvals and follow-up with appeals in... ...or GED ~ Experience in medical insurance and medical device prior authorization (preferred) ~3+ years of reimbursement process...SuggestedHourly payFull timeContract workTemporary workWork at officeRemote workMonday to FridayShift workMaven Wise
Santa Clarita, CA2 days 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 check eligibility for medical procedures and services...SuggestedHourly payFull timeWork at officeApex Practice Management Group
Northridge, CA3 days ago$51 per hour
...Utilization Review Division: MedFi Start Date: 02/17/2026 Apply Responsibilities Review prior authorization requests and clinical documentation to determine medical necessity and appropriate level of care. Apply utilization...SuggestedTotalMed Staffing
Bakersfield, CA4 days ago- ...patients 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...Suggested
BASS Medical Group
Brentwood, CA9 hours ago $17.98 - $32.12 per hour
...payers directly, utilizes approved scripting Obtains referral, authorization and pre-certification information and documents this... ...Preferred Qualifications: ~1+ years of experience with prior authorizations ~1+ years of experience working with electronic...SuggestedHourly payMinimum wageFull timePart timeWork experience placementWork at officeLocal areaMonday to FridayShift workdivvyDOSE
Walnut Creek, CA8 days ago$151k - $181.25k
...direction, adjudicate Garage Bodily Injury claims at the highest authority limits on assignments reflecting the highest degree of... ...Agencies: Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited...SuggestedLocal areaArgo Group
Los Angeles, CA2 days ago- ...resolution methods when conventional negotiation does not achieve a settlement. Complete necessary payer paperwork, including prior authorization forms and manual billing. Handle non-standard order entry situations as required. Support training needs within the team....SuggestedFull timeTemporary workPart timeShift work
Polaris Pharmacy Services
Covina, CA1 day ago $30.36 - $43.49 per hour
..., you will lead the coordination and procurement of insurance authorizations supporting the full continuum of care for stem cell transplant... ...interpretation of payer policies and coverage requirements Submit prior authorization requests and compile comprehensive clinical...SuggestedHourly payRemote workMonday to FridayUCLA Health
Los Angeles, CA2 days ago$30.37 - $59.21 per hour
...benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. • Processes requests within required timelines. • Refers...SuggestedHourly payWork experience placementWork at officeMolina Healthcare
La Mesa, CA4 days ago- ...patients' information and accurately enters it in EMA. Identifies payer sources, verifies insurance eligibility, and verifies prior authorization. Recording and collecting patient copays and/or balances at check-in/out. Other duties as assigned Qualifications:...SuggestedTemporary workWork at office
Platinum Dermatology Partners
Chula Vista, CA2 days ago $32.56 - $36.66 per hour
...accurate, and assist with general questions about appointments, authorization, payments, billing, and schedules. Patient Escalations: Seek,... ...least one of the following specialized functions: Medication Prior Authorization Specialized Data Collection & Coordination Cross...SuggestedHourly payWork at officeStanford Health Care
Palo Alto, CA3 days ago$20 - $26 per hour
...patient check-in and check-out processes, including verifying insurance coverage and collecting co-pays. Submit and track prior authorizations, ensuring all required documentation is completed and insurance requirements are met. Maintain accurate, up-to-date...SuggestedHourly payWork at officeModena Allergy + Asthma
San Diego, CA3 days 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
San Jose, CA5 days ago $21 - $24 per hour
...will have a minimum of 2 years of experience in a similar role, with a strong background in scheduling surgeries, submitting prior authorizations, working the front desk, checking in patients and providing administrative support for provider's teams. This role involves...SuggestedHourly payContract workWork at officeLocal areaImmediate startFlexible hoursJobot
San Francisco, CA4 days ago$250k - $300k
...often-complex clinical information to help formulate decisions and communicate with members, providers, and internal users. Prior Authorization. Physician shall: Understand, promote, and manage the principles of medical management to facilitate the right care...Full timeCasual workWork at officeRelocation packageFlexible hoursRegal Medical Group
Orange, CA3 days ago$1,949.74 per month
...Job Description Remote Utilization Review RN responsible for concurrent reviews, medical necessity determinations, prior authorizations, continued stay reviews, and utilization management using InterQual criteria while ensuring compliance with CMS, Medicare regulations...Weekly payRemote workShift workCynet Health
Eureka, CA5 days ago- ...Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines for nationally recognized levels of care for our Shared Services department including concurrent...Full timeWork at office
Blue Shield of CA
Redding, CA4 days ago Physician / Internal Medicine / California / Permanent / Remote Medical Director " Prior Authorizati
$250k - $300k
...San Fernando Valley and be available for occasional on-site meetings or trainings. Key Responsibilities Review and approve prior authorization requests using clinical guidelines. Collaborate with nurses, physicians, and provider groups to support cost-effective,...Permanent employmentLive inRemote workIntegrity Healthcare
Northridge, CA3 days ago- ...5 Duration: 6 months For your understanding - Do not submit if: Only MA clinical experience (no admin focus) Only call center or customer service background Epic experience outdated or minimal (pre-2021 or basic check-in only) No prior authorization history Only i......
US Tech Solutions
Redwood City, CA2 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...Work at office
Prudential Healthcare
Cerritos, CA2 days ago $23 - $25 per hour
...Prior Auth Coordinator The role of the Prior Auth Coordinator is to promptly, efficiently and accurately execute all aspects of... ...Access Express that are pended or reprocess approved or denied authorizations and package properly for review and resolution. Check...Hourly payFull timeCasual workWork at officeImmediate startRelocation packageFlexible hoursRegal Medical Group
San Bernardino, CA3 days ago$21 - $22 per hour
.... This person will work in conjunction with the providers to get approvals or denials on any medication requests and process prior authorization requests. Knowledge, Skills, and Abilities Familiar with medication names and dosages to answer medication...Full timeWork at officeCucamonga Valley Medical Group Inc
Fontana, CA4 days ago$18 - $22 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...Work at officeLocal areaMonday to FridayPhyNet Dermatology LLC
Chico, CA4 days ago- ...adjust therapy as necessary. Manage patient communications, including portal messages and results follow-up. Coordinate prior authorizations and appeals for obesity medications. Collaborate effectively with interdisciplinary team members. Contribute to the...Full time
Cedars-Sinai
Los Angeles, CA3 days ago - ...refills with the supervising pharmacist, generate refill documentation, and process third party claims adjudication. Completes prior authorizations. Enter prescription information into computer databases; accesses, processes, and retrieves data from the pharmacy system...
986 Degrees Corporation
San Gabriel, CA5 days ago $37 - $50 per hour
...license. Prefer candidates with a Bachelors of Science in Nursing (BSN) or related healthcare field. Minimum of 3+ year of prior authorization/ denials experience Minimum of 1+ year of acute care/case management experience Proficient in MS Office programs (i.e.,...Hourly payImmediate startWork from homeCareNational
Los Angeles, CA4 days ago$75.5 per hour
...clinical staff, team size is 15. -This manager will act as the UM SME for their team, managing escalations. -Candidates must have prior authorization experience (ambulatory, health plans). If candidates have only inpatient or concurrent review UM experience, that will not be...Remote workHELP-Hire
Costa Mesa, CA3 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...Full timeLive inNight shift
Neon Health
San Francisco, CA3 days ago $3,500 per week
...Cerner / Responsibilities: Discharge planning, initial assessments, coordination of post-acute care (SNF, home health, DME, prior authorizations), managing diverse patient populations (including uninsured/homeless) / Skills: Strong communication, multitasking, independent...Temporary workCasual workShift workTheraEX Staffing Services
California5 days ago
