Top 36 prior authorization specialist Jobs in pasadena ca

Patient Access Representative III - Duarte
City of Hope —Duarte, CA
- $25.78 - $36.09 an hour
- Full-time
- Hospital
- Clinic experience
- Mid-level
Collector, Management Services Organization/Centralized Billing Office - CBO - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
USC —Alhambra, CA
- $25.00 - $39.69 an hour
- 8 hour shift
- Customer service
- Research
- Mid-level
Home Infusion Authorization Intake Specialist
The Misch Group —Los Angeles, CA
- $35 - $42 an hour
- Full-time
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
12d
Patient Access Liaison - Rare Disease - US Field (West)
Amgen —Los Angeles, CA
- $158,394 - $222,256 a year
- Weekends as needed
- Doctoral degree
- Up to 50% travel
- HIPAA
- Disability insurance
- Health insurance
5d
ABA Scheduler
Center for Social Dynamics —Los Angeles, CA
- $25 - $32 an hour
- Full-time
- Remote
- Spanish
- English
- Mid-level
- 401(k)
- Tuition reimbursement
Quick Apply
1d
Prior Authorization Specialist
California Specialty Pharmacy,LLC —Whittier, CA
- Full-time
- Microsoft Word
- Microsoft Excel
- HIPAA
Quick Apply
11d
Intake Specialist
SpecialtyCare Rx —Diamond Bar, CA
- $30 - $35 an hour
- Full-time
- Management
- Mid-level
- Office
Quick Apply
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
1d
Referrals Coordinator
Clinica Romero —Los Angeles, CA
- $23.51 an hour
- Full-time
- Spanish
- HIPAA
- English
- Health insurance
Quick Apply
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
1d
Authorization Monitoring and Tracking Specialist
Allcare Home Health —Glendale, CA
- $21 - $22 an hour
- Full-time
- Mid-level
- Home Health
- Organizational skills
- Paid holidays
- Dental insurance
Quick Apply
Customer Care Specialist
SuperCare Health —City of Industry, CA
- $17.00 - $28.35 an hour
- Full-time
- Background check
- Spanish
- Microsoft Outlook
- Paid training
- Health insurance
Quick Apply
Revenue Cycle Super User
Tarzana Treatment Centers, Inc —Los Angeles, CA
- $27.77 - $31.36 an hour
- 8 hour shift
- Mid-level
- High school diploma or GED
- Analysis skills
- Paid holidays
- Health insurance
Quick Apply
Financial Care Specialist
HRC Fertility Management —Beverly Hills, CA
- $28 - $30 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Writing skills
- Health insurance
- Dental insurance
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
13d
Medical Assistant/ Insurance verifier , authorization specialist
Apex Practice Management Group —Northridge, CA
- $22 an hour
- Full-time
- Spanish
- Internal Medicine
- HIPAA
Quick Apply
Surgery Scheduler
Premier Orthopaedic Trauma Specialists —Placentia, CA
- $21 - $23 an hour
- Full-time
- Surgery
- Mid-level
- Clinic
Quick Apply
Epic Ambulatory Bones Application Engineer Specialist - 6079188
Accenture —Los Angeles, CA
- $47.85 - $57.85 an hour
- Full-time
- Remote
- 5 years
- High school diploma or GED
- US work authorization
- Disability insurance
- Health insurance
Care Coordinator
Super Care LLC —City of Industry, CA
- Ability to walk for extended periods
- HIPAA
- Mid-level
Quick Apply
6d
Customer Care Specialist
Super Care LLC —City of Industry, CA
- Full-time
- Microsoft Outlook
- Management
- Mid-level
Quick Apply
6d

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Patient Access Representative III - Duarte

City of Hope -
Duarte, CA

Apply Now

Job Details

Full-time
$25.78 - $36.09 an hour

Qualifications

Customer communication
Employee relationship building
Clinic experience
Medical scheduling
High school diploma or GED
Hospital scheduling management
Medical terminology

Full Job Description

Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.

The Patient Access Representative III is responsible for the check-in and check-out of patients on behalf of medical group physicians and other licensed providers. This role requires a high level of independent judgement in order to successfully coordinate the scheduling of patient appointments across multiple hospital departments, including rehabilitation services and ancillary departments. This individual is expected to utilize telecommunications and computer information systems to create accounts, verify information and insurance, collect co-pays (if applicable), schedule and re-schedule complex appointments. The Patient Access Representative III is best defined as a highly independent and flexible resource that focuses on system-specific service lines that are in alignment with the patient experience initiative. Furthermore, this role must multi-task between different patient care areas to ensure an extraordinary patient experience and that quality standards are met. Additional duties may include but are not limited to: physician to patient communication and serving as an information resource.

Work Schedule – 8:30 – 5pm

As a successful candidate, you will:

Registration and Scheduling:

Demonstrates an in-depth understanding of the flow of the patient registration and scheduling process within the paper and electronic environments. Registers, pre-registers, consents and schedule all patient appointment types, across the clinics, ancillary areas and hospital if applicable. Creates pre-registration record and links pre-registration record to scheduled appointments. Proactively coordinates appointments with other functional areas. Maintains department productivity, accuracy, and quality assurance standards while performing these duties. Ensures data is entered accurately for all patient demographic and insurance information. If applicable, completes all required legal documents, and obtains and scans all other related documents, may perform cash collection functions, patient pricing estimates, ETC admission.

Ensures that financial protocols and requirements are met while providing access to service at COH facilities by reviewing account documentation. Maintains and applies current knowledge of insurance requirements when verifying eligibility and confirms authorization is secured prior to forwarding patients to service delivery areas; escalates unsecure financial accounts to management. Provides patients with itineraries, advance beneficiary notice and written instructions for tests and procedures as applicable. Seeks assistance from Financial Counselors when needed to maintain patient flow while resolving financial issues and ensuring financial clearance of accounts. Provides information and assistance to patients to ensure they understand the Financial Assistance policy and application process. Provides Financial Assistance applications to all uninsured patients. This may include overseeing the process for Outpatient Medi-Cal and CCS (California Children Services) authorization, follow through for financial eligibility, and perform all functions associated with CCS/Medic-Cal outpatient rehab authorization. Screens ordered tests and communicate to physician and/or ABN Specialist those tests and/or diagnoses that do not meet criteria to be covered by Medicare.
When applicable, completes CCS / Medi-Cal Referrals on all new pediatric and adult patients and follows case until approved for coverage. Monitors CCS cases and submits medical documentation to authorize services. Assist with training of new staff on Medi-Cal and CCS regulations, and training of appropriate assignment of Plan/Carriers. Monitors the Outpatient authorization process to make sure the work is done accurately and notifies management of any problems related to this process. Prepares all forms required by Medi-Cal and CCS for treatment authorization requests (TAR) and extension in a timely manner. Compiles information on authorizations and specialized program scheduling data and prepares reports and records.
Assures that the correct pre-registration visit encounter type is linked to the scheduled appointment. Creates a request for authorization of service if applicable. Sends orders for diagnostic tests to appropriate department. Assures that documentation indicating the date of service and the visit number accompanies the orders for diagnostic testing.

Customer Service:

Ensure a high level of customer service by greeting, being a resource to patients and visitors. Serve as a liaison between patients and support staff. Develop effective relationships with colleagues, physicians, providers, leaders and other employees across the organization. Demonstrates genuine interest in helping our patients, providers and other employees by using excellent communication skills, being polite, friendly, patient and calm under pressure.
Managing multiple, changing priorities in an effective and organized manger, under stressful demand while maintaining exceptional service. Maintain composure when dealing with difficult situations and responding professionally. Independently recognize a high priority situation, taking appropriate and immediate action. Effectively communicates with service delivery and other departments to resolve issues that impact patient care and escalating issues that cannot be resolved in accordance with departmental guidelines.

Quality Assurance

Maintains appropriate level of productivity and accuracy for work performed based on department standards. Maintains thorough knowledge of policies, procedures, and standard work within the department in order to successfully performance duties on a day-to-day basis.
Performs other related duties as assigned or requested.

Your qualifications should include:

High School or equivalent
Two years related experience registering and scheduling complex patient appointments in a clinic or hospital setting. Medical terminology experience required.

City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location.

City of Hope is an equal opportunity employer.

To learn more about our Comprehensive Benefits, please CLICK HERE.

Apply Now

Refine Your Search

prior authorization specialist jobs in pasadena ca

Patient Access Representative III - Duarte

Collector, Management Services Organization/Centralized Billing Office - CBO - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

Home Infusion Authorization Intake Specialist

Patient Access Liaison - Rare Disease - US Field (West)

ABA Scheduler

Prior Authorization Specialist

Intake Specialist

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

Referrals Coordinator

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

Authorization Monitoring and Tracking Specialist

Customer Care Specialist

Revenue Cycle Super User

Financial Care Specialist

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

Medical Assistant/ Insurance verifier , authorization specialist

Surgery Scheduler

Epic Ambulatory Bones Application Engineer Specialist - 6079188

Care Coordinator

Customer Care Specialist

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