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 Insurance Authorization Specialist responsible for managing the authorization process for hospital services. Primary duties include performing telephone and online authorizations, data entry, interacting with care providers, monitoring discharge authorizations, and providing cross-functional support within the Revenue Cycle work team.

Responsibilities / Job Duties

• Perform telephone and online authorizations for routine services, contacting care providers, and monitoring concurrent and discharge authorizations.
• Perform online data entry and scanning of routine authorizations, continued stay authorizations, extended stay notices, and denial documentation.
• Assist in gathering necessary clinical information to determine continued authorization and provide associated data entry.
• Contact case managers and healthcare providers with authorization status, denial notices, and appeal process information; serve as an educational resource to primary care and specialty providers.
• Collaborate closely with case managers, medical billers, and support teams to achieve timely authorization and verification.
• Obtain required authorizations directly from health plans, Independent Physician Associations (IPAs), and medical group case managers.
• Research and resolve pending claims received without prior authorization.
• Act as a Subject Matter Expert (SME) for assigned payors as directed by Patient Access leadership while maintaining a broad operational knowledge of all payors in the facility portfolio.
• Receive incoming mail related to extended stay authorizations and manage incoming customer service calls.
• Provide cross-functional support to the broader Revenue Cycle work team as assigned.

Minimum Education and Experience Qualification Requirements

Education

• High School Diploma or GED required.

Qualifications

• Minimum of 3 years of authorization experience in a hospital setting.
• Proven ability to communicate effectively both verbally and in writing.
• Demonstrated ability to maintain a high degree of confidentiality regarding patient and facility information.
• Experience operating effectively within a unionized workforce environment.

Skills

• Good mix of billing, authorizations, and insurance verification experience in a hospital setting is preferred.

Schedule / Shift

Monday - Friday, 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.

This is a contract-to-hire opportunity with a growing team under new leadership with strong vision for the RCM team. There is planned growth and expansion as an organization.

^*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.

Any required state or Joint Commission training is compensated at the state or local minimum wage rate.

^*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.