Authorization Representative

Position Overview
We are seeking a dedicated Authorization & Insurance Verification Specialist to ensure the timely verification and validation of authorizations for all commercial and managed care inpatients, as well as other assigned services. The ideal candidate will have a strong background in working with various payors and demonstrate exceptional communication skills while building and maintaining cooperative relationships across departments.

Key Responsibilities

• Ensure timely verification and validation of authorizations for all assigned services, including commercial and managed care inpatients.
• Contact insurance companies via phone or website to secure necessary authorizations.
• Review all discharged managed care patients for authorization entry in the Authorization Module.
• Obtain missing authorizations within 3 business days of discharge or, in certain cases, within 7 days of admission.
• Conduct weekly checks on bill hold for pending authorizations.
• Assist with sending delinquent reviews and resending reviews not received by payors.
• Maintain effective communication with Case Management and other departments, fostering professional, cooperative relationships to facilitate authorization acquisition.
• Track and analyze authorization issues by payer and prepare monthly reports for senior leadership.
• Clearly document all contacts and authorization details in the hospital system, ensuring all records meet standardized documentation requirements.

Qualifications & Skills

• 2+ years of experience in authorizations and insurance verification in a high-volume setting.
• Experience working with a wide variety of payors and obtaining authorizations efficiently.
• Background in hospital settings preferred but not required.
• Strong attention to detail and ability to track and analyze authorization issues.
• Excellent communication and relationship-building skills.
• Ability to meet deadlines and follow up on outstanding authorizations within expected timeframes.

Schedule/Shift: Monday to Friday, 8:00 AM to 4:30 PM.

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Medix is acting as an Employment Business in relation to this vacancy.