Top 16 Prior authorization Jobs in Templeton, Ca

Referral Coordinator (Templeton, CA)
COASTAL COMMUNITIES PHYSICIAN NETWORK, INC —Templeton, CA
- $24.27 - $28.55 an hour
- Medical office experience
- HIPAA
- Mid-level
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Per Diem Patient Service Representative - Ambulatory Float Team (San Luis Obispo)
UCLA Health —San Luis Obispo, CA
- $33.40 an hour
- Weekends as needed
- Float pool
- Computer literacy
- Clinic
Medication Case Manager (Part Time)
Community Health Centers of the Central Coast —San Luis Obispo, CA
- $25 an hour
- Part-time
- Pass drug screening
- Mid-level
- Travel
Extended Case Manager
Restorative Partners, Inc. —San Luis Obispo, CA
- $22 - $26 an hour
- Weekends as needed
- Background check
- Spanish
- Ability to walk for extended periods
- 401(k)
- Paid time off
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OFFICE TECHNICIAN (TYPING)
California Men's Colony —San Luis Obispo County, CA
- $3,273 - $4,794 a month
- Full-time
- Current TB test
- Office
- Fingerprint clearance
9d
MEDICAL ASSISTANT
California Correctional Health Care Services —San Luis Obispo County, CA
- $3,935 - $5,175 a month
- Full-time
- Psychiatry
- High school diploma or GED
- Fingerprint clearance
- Referral program
Medical Assistant
Coastal Family Dermatology plus Aesthetics —San Luis Obispo, CA
- $20 - $26 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- HIPAA
- Paid holidays
- Health insurance
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6d
Medical Assistant
Patterson and Tedford Pediatrics —Atascadero, CA
- $25 - $27 an hour
- Email
- Background check
- LVN
- Experience working with children
- Disability insurance
- Health insurance
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11d
General Ophthalmic Surgery Coordinator
Pacific Eye Surgeons —San Luis Obispo, CA
- $23 - $28 an hour
- Surgery
- Medical office experience
- Mid-level
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Case Manager (Greenbrook)
Neuronetics —San Luis Obispo, CA
- $25 - $29 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Customer service
- Disability insurance
- Health insurance
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3d
Medication Case Manager
Community Health Centers of the Central Coast —Paso Robles, CA
- $22.50 - $24.81 an hour
- Weekends as needed
- Pass drug screening
- Mid-level
- Travel
11d
Front Desk Coordinator
Platinum Dermatology Partners LLC —San Luis Obispo, CA
- $23 - $25 an hour
- Full-time
- Basic math
- Mid-level
- High school diploma or GED
- Paid holidays
- Disability insurance
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Patient Navigator - Templeton, CA
HALO Diagnostics —Templeton, CA
- $27 - $30 an hour
- Full-time
- Spanish
- Clean driving record
- Ability to walk for extended periods
- Health savings account
- Paid holidays
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LICENSED VOCATIONAL NURSE, CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
California Correctional Health Care Services —San Luis Obispo County, CA
Possession of a valid, active license from the State of California to practice as a Licensed Vocational Nurse. Permanent, Part Time - 1/5 Time.
$1,182.60 - $1,336.40 a month

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Medical Scribe
Oak Street Health —Columbus, OH
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
$17.00 - $28.46 an hour
Ophthalmology Surgery Scheduler
Columbus Laser and Cataract Center —Westerville, OH
Meet patients to schedule their cataract or corneal surgeries, explain pre- and post-operative instructions, and answer questions.
$22 - $27 an hour
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prior authorization jobs near templeton, ca

Referral Coordinator (Templeton, CA)

COASTAL COMMUNITIES PHYSICIAN NETWORK, INC
Templeton, CA

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Job Details

$24.27 - $28.55 an hour

Qualifications

Medical office experience
High school diploma or GED
Pre-authorization review for utilization management
Medical terminology

Full Job Description

Under the direction of the Clinic Supervisor, this position is responsible to for verifying and interpreting member benefits for the health plans. The Referral Coordinator will interact with other departments, clinic personnel, and outside providers in a professional and friendly manner, to create and maintain a positive relationship with our internal and external customers.

1.1

1.1 To be efficient in use of UM prior authorization systems utilized.

1.2 Verify eligibility and benefit interpretation, via health plan and Medicare (CMS) websites.

1.3 Be a resource for providers in regard to questions regarding network specialists.

1.4 Ability to prepare authorizations and refer to appropriate providers/facilities and durable medical equipment (DME) companies.

1.5 Guide and communicate with physician office, processing staff and other departments as needed to ensure collaboration and open discussion regarding all aspects of the referral process. Including responding to messages within the next business day.

1.6 Review accuracy of pending referrals for ICD-10, CPT, HCPC code and provider selections made by the Authorization Clerk staff.

1.7 Ensure referral data entry was accurately inputted into UM systems based on the referral and clinical information submitted.

1.8 Have a complete understanding of established policy and procedure within Heritage provider network regarding the authorization processes.

1.9 Maintaining assigned duties in an acceptable manner.

1.10 Inform management on a daily basis when problems arise or when work falls behind.

1.11Compile and document good faith attempts in obtaining medical records for each pending referral when there is lack of information.

1.12 Compile clinical based guidelines, criteria and/or benefit information prior to forwarding referral to UM Managers for clinical review.

1.13 Maintain filing in a timely manner.

1.14 Provide Referral Coordinator coverage as needed.

1.15 Process referral published on daily trending reports to maintain compliance with health plans and CMS timeframe regulations.

1.16 Follow and have a complete understanding of the health plan and CMS regulations regarding timelines standards, benefit, and guideline hierarchy.

1.17 Adaptable to regulation and necessary departmental procedure changes that affect UM prior authorization processes.

1.18 Compliance with HIPM regulations and maintain patient confidentiality.

1.19 Cultural and Linguistics training required annually.

1.20 Other duties as assigned.

Requirements:
8.1 High School graduate or GED certification required.

8.2 One-year minimum experience working in a medical office environment (IPA or HMO preferred) with prior authorizations required.

8.3 Knowledge of medical terminology required.

8.4 Knowledge of HCPC, CPT and ICD-10, required.

8.5 Proficient written and oral communication skills.

8.6 Demonstrate proficiency in computer systems utilized.

8.7 Ability to remain organized and able to manage competing priorities.

8.8 Demonstrate good judgement.

8.9 Demonstrate ability to take and follow through with delegated tasks and accountability.

8.10Demonstrate resourcefulness in problem-solving.

The pay range for this position at commencement of employment is expected to be reasonably between $24.27 and $28.55. However, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience.

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

Compensation: Between $24.27 and $28.55

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Refine Your Search

prior authorization jobs in templeton, ca

Referral Coordinator (Templeton, CA)

Per Diem Patient Service Representative - Ambulatory Float Team (San Luis Obispo)

Medication Case Manager (Part Time)

Extended Case Manager

OFFICE TECHNICIAN (TYPING)

MEDICAL ASSISTANT

Medical Assistant

Medical Assistant

General Ophthalmic Surgery Coordinator

Case Manager (Greenbrook)

Medication Case Manager

Front Desk Coordinator

Patient Navigator - Templeton, CA

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