Top 40 Prior authorization specialist Jobs in Long Beach, Ca

Payor Relations Specialist - Inpatient Rehab
California Rehabilitation Institute —Los Angeles, CA
- $78,000 - $115,000 a year
- Full-time
- LVN
- RN License
- Mid-level
- Dental insurance
- Paid time off
Quick Apply
UM Coordinator, Pre-Service (Remote | Pacific Time Schedule)
Alignment Healthcare USA, LLC —Orange, CA
- $41,472 - $62,208 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Computer literacy
Quick Apply
7d
Clinical Authorization Specialist (Hospital) - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
USC —Los Angeles, CA
- $25.00 - $39.69 an hour
- 8 hour shift
- Nursing
- LVN
- Hospital
Clinical Authorization Specialist (Hospital) - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
Keck Medical Center of USC —Los Angeles, CA
- $25.00 - $39.69 an hour
- 8 hour shift
- Background check
- Nursing
- LVN
Scheduling Specialist
MemorialCare Medical Foundation —Irvine, CA
- $22.50 - $31.57 an hour
- 8 hour shift
- Customer service
- BLS Certification
- Mid-level
- Health insurance
14d
Patient Operations Specialist
Harbor Community Clinic —San Pedro, CA
- $24 - $27 an hour
- Overtime
- Background check
- Spanish
- BLS Certification
Quick Apply
Intake Coordinator - Full-Time
Oso Home Care —Irvine, CA
- $26 - $33 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Medical office experience
Quick Apply
Release of Information Specialist
Vital Holdings LLC —Los Angeles, CA
- HIPAA
- Windows
- High school diploma or GED
Quick Apply
Prior Authorization Specialist
Infusion4Health Inc —Brea, CA
- $22 - $27 an hour
- Full-time
- Microsoft Word
- Mid-level
- Office
Quick Apply
Financial Clearance Specialist IV - Admitting - Full Time 8 Hour Variable Shift (Non Union)
USC —Los Angeles, CA
- $26 - $34 an hour
- 8 hour shift
- Background check
- Medical office experience
- HIPAA
Member Services Representative
Astiva Health —Orange, CA
- $24 - $29 an hour
- Full-time
- Background check
- Spanish
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Authorization Specialist
Oso Home Care —Irvine, CA
- $21.00 - $25.90 an hour
- Full-time
- Background check
- Computer literacy
- Mid-level
- Health savings account
- Health insurance
Quick Apply
Front Office Medical Receptionist
Commons Clinic —Long Beach, CA
- $17 - $20 an hour
- Full-time
- HIPAA
- Clinic
- Perioperative Care
- Free parking
- Health savings account
Quick Apply
Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
USC —Los Angeles, CA
- $25.00 - $39.69 an hour
- 8 hour shift
- Medical office experience
- HIPAA
- Research
Health Information Specialist
Pacific Neuropsychiatric Specialists Inc —Irvine, CA
- $23 - $24 an hour
- Full-time
- Medical office experience
- Mid-level
- Computer skills
- Health insurance
- Dental insurance
Quick Apply
5d
Surgery Coordinator
Commons Clinic —Lakewood, CA
- $24 - $26 an hour
- Full-time
- Surgery
- Mid-level
- Administrative experience
- Free parking
- Health savings account
Quick Apply
Workers’ Compensation Administrative Coordinator
Southern California University —Whittier, CA
- $25 - $27 an hour
- Full-time
- Microsoft Outlook
- Computer literacy
- Mid-level
Quick Apply
Patient Services Specialist
TEEMA Group —Los Angeles, CA
- $25 - $27 an hour
- Full-time
- Physical & Rehabilitation Medicine
- HIPAA
- Mid-level
Quick Apply
11d
Release of Information Specialist Mon–Fri 8:00 AM – 4:30 PM
Vital Holdings LLC —Los Angeles, CA
- $21 - $25 an hour
- Monday to Friday
- HIPAA
- Windows
- High school diploma or GED
Quick Apply
1d
Referral Clerk
T.H.E. Health & Wellness Centers —Los Angeles, CA
- $22 - $25 an hour
- Full-time
- Bilingual
- Spanish
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply

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Payor Relations Specialist - Inpatient Rehab

California Rehabilitation Institute -
Los Angeles, CA

Quick Apply

Job Details

Full-time
$78,000 - $115,000 a year

Benefits

Dental insurance
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Paid sick time

Qualifications

Collaborate with healthcare professionals
Customer relationship building
Medicare
LVN
Referral-based lead generation
RN License
Phone communication
Customer satisfaction tracking
Mid-level
Client relationship development
Lead Conversion
Healthcare referral management
Pre-authorization review for utilization management
Customer engagement
Mentoring
Data entry
Business development within healthcare
LPN
Health insurance referral requirements
Case referral
Phone call management
2 years
Risk Mitigation
Documentation reviews

Full Job Description

Overview:

California Rehabilitation Institute

A joint venture with Select Medical, UCLA, and Cedars-Sinai Medical Center

2070 Century Pk E, Los Angeles, CA 90067

Payor Relations Specialist / Prior Authorization Specialist ( RN or LPN required )

Full-Time, Monday - Friday, 8 am - 5 pm

Annual salary ranges between $78,000 and $115,000 depending on years of previous relevant work experience.

Who We Are

Select Medical is the nation’s leading provider of long term acute care services and one of the largest providers of healthcare in the U.S. Across our network of over 47,000 employees, 120 inpatient hospitals, 1600 outpatient therapy centers and 500 urgent care facilities, our employees are guided by a set of core values and cultural behaviors that drive our hospital teams to deliver an exceptional patient experience and an exceptional employee experience.

Responsibilities:

Job Responsibilities

Using discretion and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization of referrals scheduled for admission to the Acute Inpatient Rehabilitation Hospital.

Follows the Select Workflow Process for initiating and completing patient authorizations. Takes full responsibility for following the “Workflow Process” and ensures each referral follows the process, from taking the initial referral until final disposition, acceptance or denial. As appropriate, submits the preadmission assessments completed by clinical liaisons to the insurance company.
Ensures documentation meets standards and expectations by working and mentoring team as needed.
Obtains timely authorization of all patients requiring pre-certification and is accountable for conversion percentage and results.
Ensures all policies governing commercial pre-certification and authorization are followed to minimize financial risk.
Develops relationships that increase and stabilize conversion as well as generates referrals both locally and regionally. This may include identifying relationship opportunities for self and others within Select Medical to include but not limited to CEO, DBD, CLs, Admissions Coordinator and Case Management team that may help grow relationships and impact results.
Maintains profiles on each payer to include case managers and medical directors, P2P and appeal info.
Identifies by payor communication preference and utilizes to maximize results.
Encourages and models teamwork, communication and collaboration with other departments to include but not limited to the transition of patients into the critical illness recovery hospital or acute inpatient rehabilitation hospital.
Serves as a resource to the Business Development Team educating them on payor preference to promote exceptional customer service and efficient processes
Maintains and further develops relationships with customers which may include but are not limited to surveying for satisfaction with the work of Select Medical and off-site meetings with the customer.
Evaluates Non-Medicare benefits as verified by the Central Business Office or Rehab Admissions Coordinator. Reviews benefits with Admissions Coordinator for possible risk and applies/completes written guidelines as necessary to reduce or manage risk.
Answers phone with appropriate behavior and ensures back-up when not available or out of the office.
Works closely with Admissions Coordinator to apply correct accommodation code per contract as well as billing/reimbursement requirements.
Tracks approval and denials through TOC.
Ensure outstanding customer service for all customers.
Performs other duties as requested.

Qualifications:

Minimum Qualifications

Licensure as a Registered Nurse or LVN/LPN
2 years of direct experience in third-party reimbursement
Lives in the Pacific Coast Time Zone

Preferred Experience

Previous Experience within a physical rehabilitation setting
Has California state payor knowledge
Experience working with Excel and databases

Additional Data:

Why Join Us:

Start Strong: Extensive and thorough orientation program to ensure a smooth transition into our setting
Recharge & Refresh: Generous PTO and Paid Sick Time for full-time team members to maintain a healthy work-life balance
Your Health Matters: Comprehensive medical/RX, health, vision, employee assistance program (EAP) and dental plan offerings for full-time team members
Invest in Your Future:Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members
Your Impact Matters:Join a team of over 44,000 committed to providing exceptional patient care

Equal Opportunity Employer, including Disabled/Veterans.

Quick Apply

Refine Your Search

prior authorization specialist jobs in long beach, ca

Payor Relations Specialist - Inpatient Rehab

UM Coordinator, Pre-Service (Remote | Pacific Time Schedule)

Clinical Authorization Specialist (Hospital) - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Clinical Authorization Specialist (Hospital) - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Scheduling Specialist

Patient Operations Specialist

Intake Coordinator - Full-Time

Release of Information Specialist

Prior Authorization Specialist

Financial Clearance Specialist IV - Admitting - Full Time 8 Hour Variable Shift (Non Union)

Member Services Representative

Authorization Specialist

Front Office Medical Receptionist

Financial Clearance Specialist III - PreArrival - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Health Information Specialist

Surgery Coordinator

Workers’ Compensation Administrative Coordinator

Patient Services Specialist

Release of Information Specialist Mon–Fri 8:00 AM – 4:30 PM

Referral Clerk

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