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
Note: This posted position is 1 of 3 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions.
Qualifications
We’re seeking a self-motivated, team-oriented professional with:
High school diploma, GED or equivalent
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.
At UCLA Health, you can help heal humankind, one patient at a time by improving health, alleviating suffering and delivering acts of kindness. As you do, you’ll achieve great things in your life and your career. We’re a world-class health organization with four hospitals consistently recognized among the nation’s very best as well as an internationally-renowned medical school, primary and specialty care clinics and much more. Within our dynamic, innovative and growing organization, you’ll find exceptional opportunities to make the most of your abilities in a supportive, empowering and inclusive environment. If you embrace our values of Integrity, Compassion, Respect, Teamwork, Excellence and Discovery we invite you to see all you can accomplish at UCLA Health.