Medical Authorization Assistant - Ultimate Staffing Services

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Hourly Rate: $23.92 - $33.4880

Full Office: Monday-Friday

Hours: 8am-5pm

Job Summary

Company is seeking a highly motivated an experienced Temp-Medical Authorization Assistant (UM Prior Auth) (2) to join our team. The Medical Authorization Assistant (Prior Authorization) will provide office and referral management services and serve as a contact between members, physicians, providers and staff. The incumbent will process initial intake of information, assist with authorization functions and gather information. The incumbent will be responsible for reviewing and processing requests for authorization and notification of medical services from health professionals, clinical facilities and ancillary providers. The incumbent monitor tasks related to prior authorization and referral process. Additionally, the incumbent will be responsible for applying medical criteria and policies/procedures to authorization or referral requests from medical professionals, clinical facilities and ancillary providers. The incumbent will directly interact with provider callers, acting as a resource for their needs. The incumbent will operate under the direction of the licensed nurse.

Position Information:

- Department: Utilization Management

- Salary Grade: 302 - $23.92 - $33.4880

- Work Arrangement: Full Office

Duties & Responsibilities:

- 85% - Medical Authorization Receives referral requests via fax, phone or electronically and enters new service request information into the authorization system. Collects additional information from Health members and providers to complete referral information. Authorizes requested services according to authorization guidelines, performing data entry into the authorization system and verifying eligibility. Contacts the health networks and Customer Service regarding health network enrollments. Assists the Medical Case Managers in gathering medical records, obtains appropriate coding for diagnosis and procedures and follows up on phone calls as directed by the authorization nurse. Documents all contacts and case information in the system using the standard charting format. Performs data entry into the appropriate databases for monitoring, tracking and trending of events and other relevant databases as needed.

- Receives referral requests via

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. To the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.