Top 116 Authorization specialist Jobs in San Pedro Ca

Medical Insurance Authorization Specialist
National Healthcare and Housing Advisors, LLC —Santa Ana, CA
- $73,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Sales
Quick Apply
6d
Patient Registration Rep
St Mary Medical Center —Long Beach, CA
- $25.05 - $31.47 an hour
- PRN
- Medical office experience
- HIPAA
- High school diploma or GED
Insurance Authorization Specialist Full-Time Varied
Hollywood Presbyterian —Los Angeles, CA
- $30.12 - $34.98 an hour
- 8 hour shift
- Writing skills
- Mid-level
- High school diploma or GED
Quick Apply
1d
Delegation Oversight
Champion Health Plan —Long Beach, CA
- From $60,000 a year
- Full-time
- Microsoft Excel
- LVN
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Financial Care Specialist
HRC Fertility Management —Los Angeles, CA
- $23 - $30 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Writing skills
Quick Apply
6d
Medical Assistant- Gonda Diabetes Center, Westwood
UCLA Health —Los Angeles, CA
- $29.46 - $38.87 an hour
- Overtime
- Vital signs
- OSHA
- Clinic
Payment Processing Specialist
Skilled Wound Care —Los Angeles, CA
- $21 - $26 an hour
- Microsoft Excel
- HIPAA
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
7d
Medical Assistant – Oncology, Santa Monica
UCLA Health —Santa Monica, CA
- $29.46 - $38.87 an hour
- Overtime
- Vital signs
- OSHA
- BLS Certification
Client Engagement Senior Associate, Tax Operations
Crowe —Costa Mesa, CA
- $21.75 - $44.50 an hour
- Full-time
- Hybrid work
- 5 years
- Continuous improvement
- US work authorization
Quick Apply
8d
Insurance Verification Specialist: Patient Accounting
Hoag Health System —Costa Mesa, CA
- Full-time
- Mid-level
- Windows
- High school diploma or GED
Insurance Eligibility Specialist
Memorial Health Services —Fountain Valley, CA
- $22.89 - $33.18 an hour
- 8 hour shift
- Spanish
- Hospital
- HIPAA
- Health insurance
Medical Records Specialist
Gardena Physical Therapy Inc. —Gardena, CA
- $19 - $24 an hour
- Part-time
- Medical office experience
- HIPAA
- Organizational skills
- Health savings account
- Health insurance
Quick Apply
Patient Operations Specialist
Harbor Community Clinic —San Pedro, CA
- $24 - $27 an hour
- Overtime
- Background check
- Spanish
- BLS Certification
Quick Apply
Appeals and Grievances Specialist II
L.A. Care Health Plan —Los Angeles, CA
- $60,778 - $91,166 a year
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- Office
- Wellness program
- Health insurance
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
Scheduling Specialist III: Pain Management
Hoag Health System —Huntington Beach, CA
- Microsoft Excel
- Microsoft Outlook
- Mid-level
Health Information Specialist I
Datavant —Los Angeles, CA
- $24 an hour
- Overtime
- 18 years or older
- Computer literacy
- HIPAA
- Health insurance
- Dental insurance
12d
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
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
Utilization Review Coordinator
Prosperous Health —Los Angeles, CA
- $70,000 - $80,000 a year
- Full-time
- Hybrid work
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
5d

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Medical Insurance Authorization Specialist

National Healthcare and Housing Advisors, LLC
Santa Ana, CA

Quick Apply

Job Details

Full-time
$73,000 a year
6 days ago

Qualifications

Health insurance authorizations
Microsoft Excel
Microsoft Outlook
Overseeing health insurance pre-certification
Medicare
Electronic health records (EHR) management
Phone communication
Medical insurance coverage verification
Phone call backs
Managed care organization experience
Spreadsheets
Maintaining patient confidentiality
HIPAA
High school diploma or GED
Client follow-up
Patient portals
Health information regulatory compliance
Medicaid
Managing patient records
Client interaction via phone calls

Full Job Description

The Authorizations Specialist is responsible for managing authorizations across multiple Medi-Cal managed care plans, monitoring authorization status, and ensuring timely reimbursement for services rendered. This role supports the revenue cycle by resolving authorization, eligibility, and admission-related discrepancies; reducing outstanding and aging authorizations; and escalating complex issues as needed. The ideal candidate is highly detail-oriented, organized, and persistent in follow-up efforts, with proficiency in health plan portals, electronic health record (EHR) systems, and Microsoft Excel. Strong communication skills and the ability to conduct consistent follow-up with health plans, providers, and stakeholders via phone and email are essential to success in this role.

Key Responsibilities

Submit, track, and manage authorization requests with Medi-Cal managed care plans and other payer sources to ensure timely approval of services.
Verify client eligibility, benefits, and authorization requirements prior to admission and service delivery.
Monitor authorization status through health plan portals, phone outreach, fax, and email correspondence; identify and resolve delays in processing.
Maintain accurate authorization records within the electronic health record (EHR), payer portals, spreadsheets, and internal tracking systems.
Review authorization aging reports and proactively work pending, expired, modified, denied, or unresolved authorizations to secure approval and reimbursement.
Contact health plans, payors, and utilization management departments to verify authorization status and address barriers to approval.
Research and resolve authorization denials, discrepancies, and documentation deficiencies by coordinating with clinical, admissions, billing, and care coordination teams.
Prepare and submit reconsiderations, retroactive authorization requests, and appeals with supporting documentation within required timelines.
Review service dates, approved units, levels of care, and authorization utilization to ensure services are accurately covered and documented.
Identify trends contributing to authorization delays, denials, or reimbursement issues and communicate findings to leadership.
Document all authorization activities, follow-up efforts, and payer communications thoroughly and accurately.
Collaborate with admissions, billing, coding, and program staff to resolve authorization-related discrepancies and support revenue cycle operations.
Escalate complex, high-dollar, compliance-related, or unresolved authorization issues to management as appropriate.
Assist with reimbursement reconciliation by identifying authorization-related variances between approved services and payments received.
Generate and maintain reports related to authorization status, aging authorizations, denials, approvals, and reimbursement trends.
Maintain compliance with HIPAA, payer requirements, contractual obligations, and organizational policies and procedures.
Assist with audits, record reviews, and documentation requests related to authorizations and reimbursement.
Identify opportunities to improve authorization workflows, reduce processing delays, and enhance operational efficiency.
Perform other duties as assigned in support of authorization management and revenue cycle operations.

Positions Requirements & Qualifications

Required Qualifications

High school diploma or equivalent required; Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, Public Health, or a related field preferred.
Minimum of two (2) years of experience in healthcare authorizations, utilization management, medical billing, revenue cycle, or a related healthcare administrative role.
Experience working with Medi-Cal managed care plans, health insurance payors, and authorization processes.
Proficiency with electronic health record (EHR) systems, payer portals, Microsoft Excel, and other healthcare software applications.
Strong knowledge of insurance eligibility verification, authorization requirements, reimbursement processes, and healthcare documentation standards.
Excellent organizational skills with the ability to manage multiple priorities, deadlines, and high-volume workloads.
Strong analytical and problem-solving skills with attention to detail and accuracy.
Effective verbal and written communication skills, including the ability to communicate professionally with health plans, providers, and internal stakeholders.
Ability to work independently, exercise sound judgment, and maintain confidentiality.
Knowledge of HIPAA regulations and healthcare compliance requirements.

Preferred Qualifications

Experience in recuperative care, care management, behavioral health, homeless services, or community-based healthcare programs.
Familiarity with Community Supports, or Medi-Cal managed care plan operations.
Experience preparing authorization appeals, retroactive authorization requests, and payer escalations.
Working knowledge of revenue cycle management and reimbursement processes.

Additional Preferred Skills

Sales, account management, customer service, or business development experience strongly preferred, with the ability to build relationships, conduct persistent follow-up, navigate challenging conversations, and effectively advocate with health plans and external partners.
Demonstrated ability to negotiate, influence outcomes, and maintain professional relationships while working toward authorization approvals and issue resolution.

Pay: $73,000.00 per year

Work Location: In person

Quick Apply

Refine Your Search

authorization specialist jobs in san pedro ca

Medical Insurance Authorization Specialist

Patient Registration Rep

Insurance Authorization Specialist Full-Time Varied

Delegation Oversight

Financial Care Specialist

Medical Assistant- Gonda Diabetes Center, Westwood

Payment Processing Specialist

Medical Assistant – Oncology, Santa Monica

Client Engagement Senior Associate, Tax Operations

Insurance Verification Specialist: Patient Accounting

Insurance Eligibility Specialist

Medical Records Specialist

Patient Operations Specialist

Appeals and Grievances Specialist II

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

Scheduling Specialist III: Pain Management

Health Information Specialist I

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

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

Utilization Review Coordinator

I want to receive the latest job alert for authorization specialist in san pedro ca

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