UCLA Health
Prior Authorization Coordinator - Medicare Advantage
UCLA Health, Los Angeles, California, United States, 90079
Description
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/hourQualifications
We're seeking a self-motivated, team-oriented professional with:
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
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 250 community clinics throughout Southern California. We are also home to the David Geffen School of Medicine, a highly respected leader in the development of breakthrough medical research and outstanding clinical professionals. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.
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/hourQualifications
We're seeking a self-motivated, team-oriented professional with:
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
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 250 community clinics throughout Southern California. We are also home to the David Geffen School of Medicine, a highly respected leader in the development of breakthrough medical research and outstanding clinical professionals. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.