Top 231 Authorization representative Jobs in Riverside, Ca

Denial and Appeals Management Clerk
Riverside-San Bernardino Co. Indian Health, Inc —Grand Terrace, CA
- $22 - $23 an hour
- Weekends as needed
- Hybrid work
- Background check
- BLS Certification
- HIPAA
- Health insurance
- Dental insurance
2d
Call Center Representative
University of California, Riverside —Riverside, CA
- $25.38 - $35.97 an hour
- Overtime
- Mid-level
- US work authorization
- Medical terminology
Patient Service Representative III
University of California, Riverside —Riverside, CA
- $61,282.80 - $87,821.28 a year
- Overtime
- HIPAA
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Patient Contact Center Representative/MA
University of California, Riverside —Riverside, CA
- $25.19 - $31.29 an hour
- Weekends as needed
- Vital signs
- Administrative experience
- Clinic
13d
Patient Access Center (PAC) Coordinator (Per Diem)
University of California, Riverside —Riverside, CA
- $25.38 - $35.97 an hour
- 8 hour shift
- HIPAA
- Mid-level
- US work authorization
13d
Admissions Specialist
University of California, Riverside —Riverside, CA
- $64,050 - $112,140 a year
- Weekends as needed
- Background check
- Mid-level
- University
13d
Call Center Representative
Arrowhead Orthopaedics —Riverside, CA
- Full-time
- Computer literacy
- Medical office experience
- HIPAA
12h
Secretary / Administrative Assistant (5626)
Three Saints Bay, LLC —Norco, CA
- $26.95 an hour
- Monday to Friday
- Background check
- Word processing
- ERP systems
Quick Apply
Registration Coordinator 1
Rancho Health MSO, Inc —Corona, CA
- $23 - $25 an hour
- Full-time
- Spanish
- High school diploma or GED
- US work authorization
- AD&D insurance
- Paid holidays
Quick Apply
9d
Patient Support Representative
Azul Vision —Loma Linda, CA
- $23 - $24 an hour
- 8 hour shift
- Up to 50% travel
- Computer literacy
- Mid-level
Quick Apply
9d
Patient Account Registrar - Admitting
Chino Valley Medical Center —Chino, CA
- $23 an hour
- Per diem
- Hospital
- Customer service
- Adults
- Health insurance
- Dental insurance
Regional Admissions Specialist
University of California, Riverside —Riverside, CA
- $64,050 - $112,140 a year
- Weekends as needed
- Background check
- Customer service
- Mid-level
Records Specialist I/II
City of Redlands, CA —Redlands, CA
- $46,343 - $66,408 a year
- Full-time
- Background check
- Management
- Office
- Paid holidays
- Health insurance
1d
Operations Support Assistant
Kindful Restoration —Riverside, CA
- $26 - $30 an hour
- Weekends as needed
- Microsoft Outlook
- Mid-level
- Office
- Paid holidays
- Health insurance
Quick Apply
2d
Office Manager 1
Rancho Health MSO, Inc —Corona, CA
- $70,304 - $77,000 a year
- Full-time
- Mid-level
- High school diploma or GED
- Clinic
- On-the-job training
Quick Apply
Customer Service Representative II (M-F 5:00am-1:30pm)
Niagara Bottling —Diamond Bar, CA
- $24.59 - $32.58 an hour
- Full-time
- Research
- Mid-level
- High school diploma or GED
- Health savings account
- AD&D insurance
Quick Apply
7d
Eligibility Specialist II - Bilingual
County of Riverside —Moreno Valley, CA
- $24.73 - $33.68 an hour
- Background check
- Spanish
- Hospital
- Paid holidays
- Disability insurance
1d
Conductor Trainee - Primary Recall - San Bernardino
BNSF Railway —San Bernardino, CA
- $70,000 - $82,000 a year
- Weekends as needed
- 18 years or older
- Ability to walk for extended periods
- Pass drug screening
- Health insurance
- Dental insurance
6d
UTILITIES FIELD SERVICES REPRESENTATIVE - PART TIME
City of Riverside, CA —Riverside, CA
- $24.55 - $32.90 an hour
- Part-time
- Pass drug screening
- Maintenance
- No experience needed
- Disability insurance
- Health insurance
14d
Holistic Health & Wellness Marketing Coordinator
University of California, Riverside —Riverside, CA
- $53,100 - $89,700 a year
- Full-time
- Writing skills
- Mid-level
- University

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Denial and Appeals Management Clerk

Riverside-San Bernardino Co. Indian Health, Inc -
Grand Terrace, CA

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Job Details

Full-time
$22 - $23 an hour
2 days ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Employee assistance program
Vision insurance
Employee discount
Life insurance
Retirement plan

Qualifications

Appeals
Medicare
Commercial insurance knowledge
Managed care organization experience
BLS Certification
Regulatory compliance in claims processing
HIPAA
Medical coding guidelines
High school diploma or GED
Cultural competency
Health information regulatory compliance
Medical explanation of benefits reviews
Medical claims submission
Medical Billing Certification
Clinical confidentiality policies
Insurance claims appeal handling
Medical terminology

Full Job Description

Summary:

Applicant must possess a high school diploma or equivalent. An associate degree in healthcare administration or finance is preferred. Certification as a Certified Professional Biller (CPB) is required. A minimum of two years of experience in healthcare revenue cycle, medical billing, claims processing, collections, and denial management is required. Experience with Medicare, Medi-Cal, Managed Care, and Commercial Insurance payers is required. Experience in an FQHC, Tribal Health, or community health center is preferred. NextGen experience is preferred.Must have knowledge of medical terminology, coding concepts, claim adjudication, EOBs, ERAs, payer portals, denial and appeals management, timely filing limits, and appeal processes. Experience with EHR/practice management systems, NextGen, and clearinghouses such as Waystar is preferred. Must understand healthcare regulations, coding standards, and payer requirements related to claim denials and appeals. Must be able to maintain confidentiality and ensure HIPAA compliance while prioritizing workload and consistently meeting productivity goals. Applicant must have a CPR (BLS Provider) certification through the American Heart Association (AHA) or the American Red Cross. Certification may be obtained prior to orientation or within 90 days of employment. The Denials and Appeals Management Clerk is responsible for reviewing, researching, resolving, and appealing denied or underpaid claims to maximize reimbursement and reduce accounts receivable delays. This position works closely with third-party payers, billing, coding, credentialing, providers, and internal departments to ensure timely payment, accurate claim submission, and compliance with applicable regulations. The role also analyzes denial trends, identifies payer issues, supports process improvement, and helps prevent future denials.This position is eligible for a hybrid work schedule. Must be able to work with the Indian Community and be sensitive to the Indian culture and its needs.

Major Duties and Responsibilities:

Review and prioritize high dollar and timely filing-sensitive denied claims from mail, clearinghouses, payer portals, and work queues.
Analyze denied claims, reason codes, and determine appropriate corrective actions.
Identify root causes related to coding, insurance eligibility, referral, authorization, provider documentation, or billing errors.
Correct claims and resubmit within payer filing limits
Monitor aged, denied claims, and maintain denial work queues.
Document all actions and follow-up activities in the practice management system.
Stay current on changes to payer policies, billing regulations, and reimbursement guidelines.
Adhere to patient privacy and confidentiality requirements, including HIPAA regulations.
Prepare and submit first-level and second-level appeals as appropriate.
Gather supporting medical records, referrals, authorizations, and documentation.
Draft appeal letters citing payer policies, medical necessity, coding guidelines, and regulatory requirements.
Track appeal status through payer portals, telephone calls, and payer response deadlines until resolution.
Escalate unresolved claims to management when appropriate or payer representatives.
Coordinate peer-to-peer reviews and reconsideration requests when necessary.
Identify denial trends by payer and denial reason and recurring issues.
Assist in denial prevention education and implement corrective action plans.
Collaborate with coding, billing, patient registration, medical records, and providers to prevent future denials.
Maintain denial logs and appeal tracking spreadsheets.
Support quality assurance and internal audits.
Participate in revenue cycle meetings and payer issue resolution.
Monitor denial rates and appeal outcomes.
Assist in preparing monthly reports that include denial volume, top denial categories, appeal success rates, timely filing issues, and underpayment trends.
This position requires working weekends and evenings, if needed.
Other duties assigned relevant to the position, with relevant training and competency assessment documented.

Qualifications

Education:

High School Diploma or Equivalent required. Associate degree in healthcare administration, or finance preferred.

Certification as a Certified Professional Biller (CPB) is required.

Experience:

A minimum of two years’ experience in healthcare revenue cycle, medical billing, claims processing, collections, and denial management is required. Experience with Medicare, Medi-Cal, Managed Care, and Commercial Insurance payers is required.
Experience in an FQHC, Tribal Health, or community health center is preferred.

Certification:

CPR (BLS Provider) certification through the American Heart Association (AHA) or the American Red Cross. Certification may be obtained prior to orientation. Certification may obtained within 90 days of employment.

Knowledge of:

Knowledge of medical terminology, CPT, HCPCS, ICD-10-CM Coding concepts, and claim adjudication. Explanation of benefits (EOBs), Electronic Remittance Advice (ERAs), and payer portals. Denial and Appeals Management Clerk. Familiarity with timely filing limits and appeal processes. Proficiency with Electronic Health Records and Practice Management systems (NextGen Preferred). Experience using clearinghouses such as Waystar is preferred. Knowledge of healthcare regulations, coding standards, and payer requirements relevant to claim denials and appeals.

Skill:

Strong analytical, organizational, and problem-solving skills Excellent verbal and written communication skills Microsoft Office applications. Must understand or be willing to receive Native American cultural competency training and employ cultural awareness with our Native American community.

Ability to:

Demonstrated ability to interpret claim denials, review documentation, and develop effective appeal strategies. Proven ability to investigate denials, identify root causes, and implement corrective actions. Ability to prioritize workload and consistently meet productivity goals. Ability to maintain confidentiality and ensure HIPAA compliance. Must be able to work with the Indian Community and be sensitive to the Indian culture and its needs.

Physical Demands:

This position requires prolonged sitting and computer use, occasional lifting of 20 to 25 pounds, and proficiency with computers, keyboards, and standard office equipment. Dexterity of hands with coordination of eye and hand movement.

Remote Work Eligibility:
This position may be eligible for a hybrid work schedule, eligibility is subject to supervisor approval, position requirements, and organizational needs.

Appointment Type:

Full-Time, Non-Exempt

Compensation:

$22.00–$23.00 per hour ($45,760–$47,840 annually, depending on experience and internal equity)

Clinic Location:

San Manuel Indian Health Clinic (11980 Mt. Vernon Ave. Grand Terrance Ca, 92313)

Pay: $22.00 - $23.00 per hour

Benefits:

401(k)
Dental insurance
Employee assistance program
Employee discount
Health insurance
Life insurance
Paid time off
Retirement plan
Vision insurance

Work Location: In person

Apply Now

Refine Your Search

authorization representative jobs in riverside, ca

Denial and Appeals Management Clerk

Call Center Representative

Patient Service Representative III

Patient Contact Center Representative/MA

Patient Access Center (PAC) Coordinator (Per Diem)

Admissions Specialist

Call Center Representative

Secretary / Administrative Assistant (5626)

Registration Coordinator 1

Patient Support Representative

Patient Account Registrar - Admitting

Regional Admissions Specialist

Records Specialist I/II

Operations Support Assistant

Office Manager 1

Customer Service Representative II (M-F 5:00am-1:30pm)

Eligibility Specialist II - Bilingual

Conductor Trainee - Primary Recall - San Bernardino

UTILITIES FIELD SERVICES REPRESENTATIVE - PART TIME

Holistic Health & Wellness Marketing Coordinator

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