Top 46 Authorization specialist Jobs in Walnut Creek, Ca

Authorization Specialist/ UM Trainer
Partnership HealthPlan of California —Fairfield, CA
- $36.00 - $45.01 an hour
- Mid-level
- Office
- Driver's License
Operations Specialist, Experienced
Blue Shield of California —Oakland, CA
- $32.03 - $48.04 an hour
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- Microsoft Outlook
- Work from home
10d
Operations Specialist, Senior
Blue Shield of California —Oakland, CA
- $81,950 - $122,870 a year
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- Microsoft Outlook
- Work from home
10d
Billing Specialist On-site (Medi-Cal, SSI, ALW) - Multi Facility Organization
Alamo Health Management —San Ramon, CA
- $93,600 - $104,000 a year
- Full-time
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
19h
Sr. Professional Fee Coder - Analyst III (F/T) - (Sign-On Bonus eligible)
University of California San Francisco —Emeryville, CA
- From $119,809 a year
- Full-time
- 3 years
- High school diploma or GED
- Analysis skills
Claims Resolution Specialist
Integrated Pain Management Medical Group, Inc. —Walnut Creek, CA
- $28 - $35 an hour
- Full-time
- HIPAA
- Research
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Prior Authorization Specialist
PHIL —San Francisco, CA
- $19 - $22 an hour
- Full-time
- Mid-level
- Office
- Reliable transportation
Quick Apply
Utilization Management Coordinator - Casual
Altais Health Solutions —Oakland, CA
- $25 - $30 an hour
- Full-time
- Background check
- Medical office experience
- Pass drug screening
- Paid holidays
- Health insurance
Quick Apply
8d
Patient Auth and Referral Specialist I
CareMore Health Management Services, LLC —San Francisco, CA
- $19.80 - $29.70 an hour
- Full-time
- Medical office experience
- HIPAA
- High school diploma or GED
Quick Apply
2d
Eligibility Specialist (Contract)
Midi Health —San Francisco, CA
- $20 an hour
- Contract
- Remote
- Mid-level
- US work authorization
- 2 years
Quick Apply
Compliance & Outcomes Specialist
Hike Medical —San Francisco, CA
- $140,000 - $200,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- Commercial
Medical Assistant & Patient Care Coordinator
BASS MEDICAL GROUP —Walnut Creek, CA
- $28 - $32 an hour
- Full-time
- Vital signs
- Neurology
- Organizational skills
Quick Apply
Lead Medical Billing Specialist
North Bay Aesthetics —San Francisco, CA
- $40 - $50 an hour
- Full-time
- Mid-level
- Supervising experience
- Mentoring
- Health insurance
- Dental insurance
Quick Apply
2d
Customer Service Representative
QUIPT HOME MEDICAL INC —Walnut Creek, CA
- Microsoft Excel
- High school diploma or GED
- Typing
- Paid holidays
- Disability insurance
Quick Apply
Administrative Operations Specialist- (Housing Operations Professional II, Range 1) - HDCS Housing, Dining and Conference Services
California State University —San Francisco, CA
- Full-time
- Background check
- Research
- Mid-level
- Health savings account
- Disability insurance
DME Documentation Criteria Reviewer
Hike Medical —San Francisco, CA
- $90,000 - $145,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- Commercial
Esthetician Support Specialist
Face Reality —San Ramon, CA
- $31 - $33 an hour
- Full-time
- Hybrid work
- Clean driving record
- Ability to walk for extended periods
- Computer literacy
Quick Apply
Clinical Support Specialist
PHIL —San Francisco, CA
- $26 - $28 an hour
- Full-time
- Remote
- Continuous improvement
- 2 years
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
Medical Staff Analyst
University of California San Francisco —San Francisco, CA
- Full-time
- Microsoft Excel
- Mid-level
- Office
Organ Allocation Coordinator I
Donor Network West —San Ramon, CA
- $25.24 - $31.55 an hour
- Weekends as needed
- Remote
- Customer service
- Mid-level
- Continuous improvement
Quick Apply

I want to receive the latest job alert for authorization specialist in walnut creek, ca

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

authorization specialist jobs near walnut creek, ca

Administrative Specialist jobs in San Francisco, CA

Staff Services Analyst jobs in San Francisco, CA

Operations Associate jobs in Oakland, CA

Medical Biller jobs in San Francisco, CA

Patient Care Coordinator jobs in Walnut Creek, CA

Clinical Support Specialist jobs in San Francisco, CA

Eligibility Specialist jobs in San Francisco, CA

Esthetician jobs in San Ramon, CA

Compliance Officer jobs in San Francisco, CA

Customer Service Representative jobs in Walnut Creek, CA

Billing Specialist jobs in San Ramon, CA

Referral Specialist jobs in Macon, GA

Referral Specialist jobs in Hartford, CT

Customer Support Specialist jobs in Seattle, WA

Referral Specialist jobs in Portland, ME

Referral Specialist jobs in Chapel Hill, NC

Inventory Specialist jobs in San Diego, CA

Referral Coordinator jobs in Sacramento, CA

Peer Support Specialist jobs in Staten Island, NY

Organ Transplant Coordinator jobs in Boston, MA

Authorization Specialist/ UM Trainer

Partnership HealthPlan of California -
Fairfield, CA

Apply Now

Job Details

$36.00 - $45.01 an hour

Qualifications

Computer operation
Phone communication
Customer inquiry handling
Driver's License
Data entry
Typing

Full Job Description

Overview

To process TARs for selected services using specific procedures and protocol and to provide administrative assistance to UM Coordinators and Leadership staff as assigned. Serves as Systems Trainer for all new hires and provides ongoing education for all HS/UM staff.

Responsibilities

Prepares and maintains up-to-date training and educational materials for new and existing staff.

Provides hands-on training during new hire orientation.

Collaborates in the on-going trainings for staff education of latest department changes and updates, which includes but is not limited to NCQA standards, Whole Child Model and Essette. As well as, develop and distribute supporting material

Works closely with UM leadership to produce staff enhancement trainings, which includes development of the agenda, preparing materials and handouts, presenting the training in conjunction with leadership presenters.

Provides training not only to the designated department HS/UM but also HS/CC and internal Partnership’s departments that require support and knowledge of UM’s program and TAR process.

Monitors and has full proprietorship of the UM Departments Help Desk, which includes assessing inquires, and either resolving or escalating to appropriate staff as needed

Supports the successful implementation of the UM Department’s software systems and online services, proceeding the participation of a testing environment.

Processes Treatment Authorization Requests (TARs) pertaining to wheelchairs, diabetic shoes, nebulizers, dialysis, and Hospice services, etc.

Assists in determining appropriateness, quality and medical necessity for all specialty related medical equipment for pediatrics open to Whole Child Model, and necessity of DME for children enrolled with a County MTU Clinic.

Works with appropriate consultants to facilitate the need for an in-home assessment to determine the medical necessity of DME equipment.

Assists network providers and other departments with issues concerning TARs.

Acts as a resource regarding UM department computer programs and special projects upon request.
Verifies member’s eligibility and designated program benefits.

Elicits medical information from provider, consulting with HS/UM clinical staff as appropriate.
Monitors consultant’s turnaround time and initiates follow-up as necessary.

Prepares Medical Director work sheet for review by Chief Medical Officer (CMO) or physician designee as appropriate.
If not approved by consultant, reassigns TAR to UM Clinical Coordinator for processing.

Provides overflow support to both Data Coordinators and Nurse Coordinators.

Participates in special projects and assignments as required.
Assists in the refinement/improvement of the UM Department by participating in continuous process improvement endeavors.
Other duties as assigned.

Qualifications

Education and Experience

Certified Medical Assistant or minimum one (1) year experience in the medical/clerical field; or equivalent combination of education and experience. General knowledge of managed care with emphasis in UM preferred.

Special Skills, Licenses and Certifications

Ability to work within an interdisciplinary team structure and function in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Effective telephone and computer data entry skills required. Ability to access data and information using automated systems. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business.

Performance Based Competencies

Excellent written and verbal communication skills. Ability to follow established procedures and protocol. Ability to communicate effectively with coworkers, physicians, and health care providers.

Work Environment And Physical Demands

Daily use of telephone and computer for most of the day. Cubicle work station. Ability to use a computer keyboard. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs.

All HealthPlan employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$36.00 - $45.01

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Apply Now

Refine Your Search

authorization specialist jobs in walnut creek, ca

Authorization Specialist/ UM Trainer

Operations Specialist, Experienced

Operations Specialist, Senior

Billing Specialist On-site (Medi-Cal, SSI, ALW) - Multi Facility Organization

Sr. Professional Fee Coder - Analyst III (F/T) - (Sign-On Bonus eligible)

Claims Resolution Specialist

Prior Authorization Specialist

Utilization Management Coordinator - Casual

Patient Auth and Referral Specialist I

Eligibility Specialist (Contract)

Compliance & Outcomes Specialist

Medical Assistant & Patient Care Coordinator

Lead Medical Billing Specialist

Customer Service Representative

Administrative Operations Specialist- (Housing Operations Professional II, Range 1) - HDCS Housing, Dining and Conference Services

DME Documentation Criteria Reviewer

Esthetician Support Specialist

Clinical Support Specialist

Medical Staff Analyst

Organ Allocation Coordinator I

I want to receive the latest job alert for authorization specialist in walnut creek, ca

Explore jobs in more locations

Overview

Responsibilities

Qualifications

Job Seeker Tools

Employer Tools

Browse

Stay Connected