Nashville, Tennessee
Baltimore, Maryland
Baltimore, Maryland
Posted: 05-Feb-25
Location: Los Angeles, California
Categories:
Internal Number: 146106692
Take on an important role within an award-winning health organization. Help ensure the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health.
You will receive urgent, routine, pre-service, and retro authorization requests, as well as process prior authorization requests with accuracy and timeliness. This will involve the use of various business applications to perform analysis, obtain information, and enter prior authorization data necessary for claims adjudication. You will use your critical thinking skills to identify missing information and make prior authorization processing determinations based on clinical protocols and other guidelines. You will also interact with internal and external customers to provide and obtain information and ensure the delivery of outstanding service and quality.
Salary Range: $29.42-$42.14/hour
- High school diploma, GED or equivalent experience
- One or more years of experience working in a managed care environment preferred
- Experience processing ambulatory commercial, Medicare Fee for Service, Medicare Advantage prior authorizations a plus
- Knowledge of the HMO referral process, eligibility verification, and health plan benefit interpretation desired
- Strong communication, organizational, critical thinking, and problem-solving skills
- Ability to work effectively across functional areas of the company
- Excellent execution and follow-up abilities
- Computer proficiency with Microsoft Office
- Ability to multi-task, work with frequent interruptions, and meet deadlines
- Detailed and goal orientation
- Ability to cope well with ambiguity and stressful situations
- Ability to maintain confidentiality of patient and business records
