You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking an Authorization Specialist who will be responsible for overseeing clinical authorizations and compliance, acting as a liaison between patients and insurance payers, and managing financial navigation for patients requiring chemotherapy treatments.

Key Responsibilities

• Clinical Authorization & Compliance: Audits medical necessity for chemotherapy treatments and ensures strict adherence to clinical pathways and regimen documentation.
• Insurance Advocacy & Liaison: Acts as a primary liaison between patients and payers to resolve reimbursement inquiries, prevent delays, and secure necessary pre-certifications.
• Financial Navigation: Researches alternative funding for non-covered services and provides patients with comprehensive resources for pharmaceutical assistance and financial aid.
• Clinical Communications: Advises medical and nursing staff on insurance-specific restrictions and provides real-time feedback to management regarding payer trends or drug coverage issues.
• Revenue Cycle Support: Manages denials, processes write-offs/adjustments, and maintains meticulous reimbursement records while providing coverage for Patient Financial Counselors.
• Regulatory Expertise: Maintains up-to-date knowledge of state/federal regulatory guidelines and chemotherapy authorization requirements while ensuring total HIPAA compliance.

Qualifications

• High School Diploma or GED
• 2 Years of Medical Insurance Verification and/or Authorization Experience
• Medical Billing and Coding Experience (preferred)

Skills

• Strong communication and advocacy skills
• Knowledge in medical billing and coding
• Experience in insurance verification and authorization

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.

^*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).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. 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.