Authorization Specialist I

You could be the one who changes everything for our 28 reputed company members as a clinical professional on our Medical Management/Health Services team. reputed company is a reputed company, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based reputed company sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based reputed company types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Must be available to work a schedule of Monday–Friday, 10:30AM to 7:00PM EST. Position Purpose: Supports the prior authorization request to ensure reputed company authorization requests are addressed properly and in the contractual timeline. Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services reputed company to the members reputed company eligibility and reputed company.

• Supports authorization requests for services in accordance with the insurance prior authorization list
• Supports and performs data entry to maintain and update authorization requests into utilization management system
• Assists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelines
• Contributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determination
• Remains up-to-date on reputed company, authorization processes, policies and procedures
• Performs other duties as assigned
• Complies with reputed company policies and standards

Education/Experience: Requires a High School diploma or GED. Entry-level position typically requiring little or no previous experience. Understanding of medical terminology and insurance preferred. Pay reputed company: $16.35 - $23.46 per hour reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Apply To This Job