Top 71 Prior authorization Jobs in El Dorado Hills, Ca

Clinical Services Coordinator, Intermediate
Blue Shield of California —El Dorado Hills, CA
- $21.73 - $30.43 an hour
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Research
- Work from home
1d
Pharmacy Technician, Intermediate
Blue Shield of California —Rancho Cordova, CA
- $21.73 - $30.43 an hour
- Weekends as needed
- Hybrid work
- Background check
- Pass drug screening
- Mid-level
- Work from home
Home Infusion Intake Specialist
UC Davis Health —Sacramento, CA
- $30.65 - $38.10 an hour
- 8 hour shift
- Background check
- Customer service
- Writing skills
- Continuing education credits
- Paid holidays
2d
Patient Access Representative Full Time
West Coast Joint and Spine (13106) —El Dorado Hills, CA
- $25 an hour
- Full-time
- HIPAA
- Typing
- Outpatient
- Health savings account
- AD&D insurance
Eligibility and Authorization Specialist
Retina Sacramento MSO LLC —Sacramento, CA
- $19.60 - $25.00 an hour
- Full-time
- Writing skills
- Communication skills
- Entry level
- Paid holidays
- Health insurance
2d
Patient Service Representative 2
UC Davis Health —Sacramento, CA
- $28.97 - $35.93 an hour
- Overtime
- Background check
- Word processing
- Writing skills
- Continuing education credits
- Paid holidays
10d
Senior Central Prior Authorization Analyst
Adventist Health —Roseville, CA
- $30.91 - $39.73 an hour
- 6 years
- Office
- High school diploma or GED
Medical Receptionist
Pirsaheli, MD —Folsom, CA
- $23 - $25 an hour
- Part-time
- HIPAA
- Neurology
- Organizational skills
Quick Apply
8d
Patient Services Representative 2
UC Davis Health —Sacramento, CA
- $28.97 - $35.93 an hour
- Overtime
- Background check
- Word processing
- Writing skills
- Continuing education credits
- Paid holidays
3d
OFFICE TECHNICIAN (TYPING)
Department of Social Services —Sacramento County, CA
- $3,829 - $4,794 a month
- Full-time
- Hybrid work
- Microsoft Word
- Microsoft Excel
- Office
- Paid holidays
- Health insurance
Medical Insurance Authorization and Billing Specialist
A Senior Connection —Sacramento County, CA
- $55,000 - $80,000 a year
- Full-time
- Hybrid work
- Background check
- Google Workspace
- HIPAA
- Health insurance
- 401(k)
Quick Apply
7d
Outgoing Authorization Coordinator & Front/Back Office Float Position
TRAVIS LOIDOLT DO INC —Roseville, CA
- $24 - $26 an hour
- Full-time
- Float pool
- Mid-level
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
Care Management - Nurse, Senior
Blue Shield of California —El Dorado Hills, CA
- $90,860 - $136,290 a year
- Weekends as needed
- Hybrid work
- Background check
- Nursing
- 5 years
- Work from home
Customer Care Specialist
Super Care, LLC —Rancho Cordova, CA
- $17.00 - $28.35 an hour
- Full-time
- Spanish
- Microsoft Outlook
- Computer literacy
- Paid training
- Health insurance
Quick Apply
Healthcare Coordinator
PDS Health —Folsom, CA
- $20.75 - $29.00 an hour
- Full-time
- Dental office
- Computer literacy
- Local
- Health insurance
- Dental insurance
2d
Patient Services Representative 2 Per Diem
UC Davis Health —Sacramento, CA
- $32.75 an hour
- Overtime
- Background check
- Word processing
- Writing skills
- Continuing education credits
- Paid holidays
8d
MANAGER III, DEPARTMENT OF MOTOR VEHICLES
Department of Motor Vehicles —Sacramento County, CA
- $6,681 - $8,362 a month
- Online Application
- Management
- Office
- Travel
- Disability insurance
- Health insurance
14d
Referral Coordinator
Capital Allergy & Respiratory Disease Center —Roseville, CA
- From $21 an hour
- Full-time
- Background check
- HIPAA
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Medical Referral / Scheduling Coordinator
Sacramento Heart & Vascular Medical Associates —Sacramento, CA
- $20 - $24 an hour
- Overtime
- HIPAA
- Office
- Microsoft Office
- Health insurance
- Dental insurance
Quick Apply
2d
Admissions Assistant
Western Slope Health Center —Placerville, CA
- $23 - $27 an hour
- Full-time
- Skilled nursing facility
- Organizational skills
- Communication skills
- Opportunities for advancement
Quick Apply

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Clinical Services Coordinator, Intermediate

Blue Shield of California -
El Dorado Hills, CA

Apply Now

Job Details

Full-time
$21.73 - $30.43 an hour
1 day ago

Benefits

Work from home

Qualifications

High school diploma or GED

Full Job Description

Your Role

The Medical Care Solutions Federal Employee Program team provides prior authorization and utilization management services to our members. The Clinical Support Coordinator will report to the Operations Management Supervisor. In this role you will be responsible for answering a high-volume of inquiry calls, and advising or requesting from doctor’s offices if prior authorization is required for a given service. You will also receive and process admits from hospitals when members are admitted to a facility as well as processing prior authorization fax requests.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work
In this role, you will:

Answer a high volume of phone inquiries and load faxed authorizations
Data entry including authorization forms, high risk member information, verbal HIPPA authorizations information for case creation
Support to Advanced/Specialist CSC
Assign initial EOA days, or triage to nurses, based on established workflow
Research member eligibility/benefits and provider networks
Verify member eligibility
Process hospital admits
Send referrals to Case Management as appropriate
Other duties as assigned

Your Knowledge and Experience

Requires a high school diploma or equivalent
Requires at least 3 years of prior relevant experience preferably including answering a large volume of inbound calls
Strong attendance record preferred
Solid technical skills – ability to navigate MS programs and learn in-house software
Sharp communication and teamwork skills
Preferred – experience within FEP using AuthAccel

Hybrid Virtual Work
This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

ABOUT THE TEAM
About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

For most teams, this means coming into the office two days per week.
Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Apply Now

Refine Your Search

prior authorization jobs in el dorado hills, ca

Clinical Services Coordinator, Intermediate

Pharmacy Technician, Intermediate

Home Infusion Intake Specialist

Patient Access Representative Full Time

Eligibility and Authorization Specialist

Patient Service Representative 2

Senior Central Prior Authorization Analyst

Medical Receptionist

Patient Services Representative 2

OFFICE TECHNICIAN (TYPING)

Medical Insurance Authorization and Billing Specialist

Outgoing Authorization Coordinator & Front/Back Office Float Position

Care Management - Nurse, Senior

Customer Care Specialist

Healthcare Coordinator

Patient Services Representative 2 Per Diem

MANAGER III, DEPARTMENT OF MOTOR VEHICLES

Referral Coordinator

Medical Referral / Scheduling Coordinator

Admissions Assistant

I want to receive the latest job alert for prior authorization in el dorado hills, ca

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