Authorization Representative

Job Title: Authorizations Representative

Work Location: Irvine, CA (hybrid/ remote potential after contracted hours are met)

Job Description:

We are seeking a dedicated Authorization Representative to join our team and provide essential coverage during an extended leave. This role is critical in maintaining the smooth operation of our authorization process, especially with the high volume of Medi-Cal insurance cases within our Los Angeles-based patient population. Candidates with experience in authorizations, particularly for Medi-Cal and a range of government and commercial insurance plans, are encouraged to apply. With anticipated team growth, this position offers a strong potential for long-term placement for the right candidate.

Responsibilities/ Job Duties:

• Submit authorizations for various insurance payers (excluding Cigna and Healthnet) through electronic portals, fax, or phone as required.
• Conduct eligibility checks and authorization follow-ups, updating patient charts and coordinating with scheduling as needed.
• Collaborate closely with the pharmacy department to maintain compounding records and ensure accuracy in patient records.
• Provide quality customer service when speaking with patients regarding their authorization status or eligibility.
• Manage daily metrics of 30-40 authorizations for enterals, specialty medications, and per diems, ensuring timely and accurate processing.

Minimum Education and Experience Requirements:

• Authorization Experience: Familiarity with Medi-Cal authorizations is essential; experience with home health, pharmacy, and home infusion therapy is highly desirable.
• Insurance Knowledge: Proven track record working with multiple payers, including both government and commercial plans.
• Customer Service: Comfortable engaging directly with patients to communicate updates and answer questions professionally.

Reliability: Dependable attendance and punctuality are critical, as this role impacts the workflow of the entire company.

Schedule/ Shift: M-F 8am - 5pm

Benefits:

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances)

• Health Benefits / Dental / Vision (Medix Offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s).)

• 401k (eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1)

• Short Term Disability Insurance

• Term Life Insurance Plan

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