Top 28144 Authorization representative Jobs

Member Service Representative
Champion Health Plan/ Champion Payer Solutions —Long Beach, CA
- From $22 an hour
- Weekends as needed
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Authorization Specialist (in-person)
North Shore Pain Management —Beverly, MA
- $20 - $25 an hour
- Full-time
- Background check
- Private practice
- HIPAA
- Paid holidays
- Health insurance
Quick Apply
Authorization Specialist (in-person)
North Shore Pain Management —Danvers, MA
- $20 - $25 an hour
- Full-time
- Background check
- Private practice
- HIPAA
- Paid holidays
- Health insurance
Quick Apply
Billing and Collections Representative
Always Home Care —Brooklyn, NY
- $50,000 - $80,000 a year
- Full-time
- Management
- Research
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Authorizations Representative
HAMASPIK CHOICE INC —Spring Valley, NY
- $21 - $23 an hour
- Full-time
- Computer literacy
- Entry level
Quick Apply
Scheduling and Prior Authorization Representative- Remote
McKenzie Health —Watford City, ND
- Weekends as needed
- Remote
- Background check
- Word processing
- Computer literacy
- 403(b) matching
- Employee assistance program
Quick Apply
12d
Authorization Representative
Therapeutic Associates Physical Therapy —Remote
- $17 - $20 an hour
- Full-time
- Remote
- Customer service
- Medical office experience
- Physical & Rehabilitation Medicine
- Profit sharing
- Wellness program
Quick Apply
12d
AR Call Representative 1
Performance Home Medical —Houston, TX
- Full-time
- Remote
- Entry level
- AD&D insurance
- Paid holidays
Quick Apply
Prior Authorization Representative- Evernorth- Remote
The Cigna Group —New Jersey
- $17.75 - $26.00 an hour
- Online Application
- Remote
- Microsoft Excel
- Microsoft Outlook
- Administrative experience
- Paid holidays
- Health insurance
1d
Customer Service Representative
QUIPT HOME MEDICAL INC —Wilder, KY
- Microsoft Excel
- High school diploma or GED
- Typing
- Paid holidays
- Disability insurance
Quick Apply
Authorization Specialist - Revenue Cycle Management
Vital Care Infusion Services —Remote
- $18.92 - $23.46 an hour
- Full-time
- Remote
- Writing skills
- English
- Mid-level
- Health savings account
- Paid holidays
Quick Apply
DME Authorization Representative
The Centers for Advanced Orthopaedics —Hagerstown, MD
- Full-time
- Mid-level
Quick Apply
Insurance Authorization Specialist II
SYSTEM West Virginia University Health System —Remote
- Full-time
- Remote
- Microsoft Outlook
- Computer literacy
- Basic math
Remote Healthcare Call Center Representative
Conduent Commercial Solutions, LLC —Remote
- $16.50 an hour
- Weekends as needed
- Remote
- Background check
- High school diploma or GED
- Typing
- Paid training
- Paid holidays
5d
Authorization Representative
KabaFusion —Edison, NJ
- $22 - $28 an hour
- Full-time
- Microsoft Excel
- HIPAA
- Research
- Paid holidays
- Disability insurance
Quick Apply
Branch Coordinator - Remote
Apria Healthcare LLC —Los Angeles, CA
- $20 - $25 an hour
- Full-time
- Remote
- Computer literacy
- Writing skills
- English
- Paid parental leave
- Disability insurance
Quick Apply
Pre-Authorization Representative
SimonMed Imaging —Reno, NV
- Full-time
- Background check
- Mid-level
- Experience equivalent to degree accepted
- Paid holidays
- Health insurance
Quick Apply
Patient Access Representative (REMOTE)
Aveanna Healthcare —Houston, TX
- $18 - $19 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Medical office experience
- Paid holidays
- Health insurance
Quick Apply
14d
Radiology Patient Scheduling Representative
T2 Group —Conyers, GA
- $18 an hour
- Full-time
- Remote
- Background check
- Microsoft Excel
- Microsoft Outlook
- 401(k)
- Work from home
Quick Apply
Pharmacy Care Representative - Work From Home New Jersey
CVS Health —New Jersey
- $17.00 - $31.30 an hour
- Overtime
- Remote
- Microsoft Excel
- Microsoft Outlook
- Windows
- Paid holidays
- Health insurance
13d

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Member Service Representative

Champion Health Plan/ Champion Payer Solutions
Long Beach, CA

Quick Apply

Job Details

Full-time
From $22 an hour

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Flexible schedule

Qualifications

Spanish
Customer communication
Teamwork
Customer retention
Managed care
Managed care organization experience
Call center experience
HIPAA
English
Vietnamese
High school diploma or GED
Medical terminology

Full Job Description

SCOPE OF ROLE

The Member Service Representative (MSR) serves as the first point of contact for customers, providers, and advocates, ensuring exceptional customer experiences through accurate and helpful communication. This role involves handling incoming calls from Medicare Advantage members, assisting with benefit inquiries, referrals, claims, and guiding them to community resources as needed. The ideal candidate will be bilingual, proficient in medical terminology, and knowledgeable in CMS, Medicare, and HIPAA regulations. Strong proficiency in Microsoft Applications and a commitment to delivering top-tier service are essential.

ROLE RESPONSIBILITIES

The Member Service Representative job description is intended to point out major responsibilities within the role, but it is not limited to these functions:

KEY RESPONSIBILITIES % OF TIME

 Serve as the primary point of contact for customers, providers, and advocates, handling calls with professionalism and courtesy.

 Provide clear, concise, and accurate information to ensure customers fully understand their benefits, referrals, claims, and available resources.

 Ensure prompt and efficient service by answering all incoming calls within the

department’s established time frame.

 Escalate complex issues to management or relevant departments as necessary to

ensure customer concerns are thoroughly addressed.

 Collaborate with internal teams to resolve problems and enhance overall customer

satisfaction.

 Accurately document customer interactions, including actions taken, resolutions

provided, and any follow-up required.

 Adhere to department policies and HIPAA regulations to maintain confidentiality and

security of member information.

 Manage complaints, grievances, and appeals efficiently according to department

protocols.

 Assist in onboarding and training new staff, sharing knowledge and best practices.

 Complete required training promptly to stay current with procedures, systems, and

regulations.

 Consistently meet or exceed standards for quality, productivity, and adherence to

schedules.

 Participate in outbound call campaigns for welcome calls, enrollment verification calls, appointment scheduling,

retention efforts, and other health-related programs.

 Contribute to policy and procedure development related to customer experience.

 Stay updated on CMS, Medicare, and HIPAA regulations to ensure compliance and

provide accurate information.

 Utilize medical terminology and healthcare knowledge to assist members with inquiries.

 Adapt to changes in shifts, responsibilities, and operational needs as required.

 Facilitate member requests for provider changes, transportation, and other assistance.

 Maintain a positive attitude and practice excellent customer service principles.

 Perform other duties as assigned to contribute to the team and department’s success

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

 High School diploma or GED required.

 Associate degree (AA) degree (preferred).

 Minimum (2) or more years of direct customer service EXPERIENCE

 Knowledge of Medi-Cal, Medicare Managed Care Plans.

 Medical front office experience preferred.

PROFESSIONAL COMPETENCIES

 Strong communication skills (verbal and written).

 Highly organized with the ability to prioritize work to meet deadlines.

 Strong adaptability and openness to change.

 Knowledge of HIPAA regulations with a commitment to data privacy.

 Strategic skills in problem-solving, critical thinking, and innovation.

 Ability to collaborate effectively with business partners throughout the organization.

 Experience assisting members with Medicare Advantage or HMO, including referrals and authorizations.

 Outbound/inbound call center experience with a focus on problem-solving and escalation.

 Bilingual in English/Spanish or Vietnamese/English required.

 Proficiency in Microsoft Applications (Word, Excel, Outlook).

 Ability to multitask and prioritize tasks effectively.

 Flexibility to work varying shifts, including evenings and weekends.

LICENSURES AND CERTIFICATIONS

No licensures or certifications are required.

WORK ENVIRONMENT and ESSENTIAL PHYSICAL FUNCITONS:

Work Environment:

 Must be available for scheduling 7 days a week, including evenings, overnights, weekends, and holidays.

 Shifts may change based on operational needs; flexibility is essential.

Essential Physical Functions:

 Ability to work onsite in an open office setting, primarily sitting at a desk and working on a computer.

 Regularly required to talk, hear, stand, walk, sit, and use hands to handle or feel objects and controls.

 Frequently lifts/moves up to 10 pounds. Specific vision abilities include close vision and the ability to adjust focus.

EEO/AFFIRMATIVE ACTION STATEMENT

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse group of employees committed to meeting the needs of Champion Payer Solutions/ Champion Health Plan, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Job Type: Full-time

Pay: From $22.00 per hour

Benefits:

401(k)
Dental insurance
Flexible schedule
Health insurance
Paid time off
Vision insurance

Experience:

Managed care: 2 years (Required)

Language:

Spanish (Preferred)
Vietnamese (Preferred)

Ability to Commute:

Long Beach, CA 90815 (Required)

Ability to Relocate:

Long Beach, CA 90815: Relocate before starting work (Preferred)

Work Location: In person

Quick Apply

Refine Your Search

authorization representative jobs

Member Service Representative

Authorization Specialist (in-person)

Authorization Specialist (in-person)

Billing and Collections Representative

Authorizations Representative

Scheduling and Prior Authorization Representative- Remote

Authorization Representative

AR Call Representative 1

Prior Authorization Representative- Evernorth- Remote

Customer Service Representative

Authorization Specialist - Revenue Cycle Management

DME Authorization Representative

Insurance Authorization Specialist II

Remote Healthcare Call Center Representative

Authorization Representative

Branch Coordinator - Remote

Pre-Authorization Representative

Patient Access Representative (REMOTE)

Radiology Patient Scheduling Representative

Pharmacy Care Representative - Work From Home New Jersey

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