- Expertini Resume Scoring: Our Semantic Matching Algorithm evaluates your CV/Résumé before you apply for this job role: Authorization Technician II (12 Month Assignment).
Urgent! Authorization Technician II (12 Month Assignment) Job Opening In Los Angeles – Now Hiring L.A. Care Health Plan
Job Summary
The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all administrative and technical functions of the authorization process including intake, logging, tracking and status follow-up.
The Authorization Technician II collects information required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in meeting regulatory time lines by maintaining an accurate database inventory of referral authorizations, retrospective reviews, concurrent reviews and grievance/appeal requests, and prepares UM Activity and Weekly Compliance Reports.
In addition, the position performs data entry and processing of referrals/authorizations in the system, authorizes request consistent with auto authorization criteria, maintains confidentiality when communicating member information, and assists with the communication of determinations by preparing template letters for members/ providers, with other duties as assigned.
Duties
Functional Elements: Technical Support to UM Specialist: Processing of time sensitive authorization and pre-certification requests to meet department timeframes and regulatory requirements; Computer Input: Accurately and completely processing referrals/authorizations and distribute a complete file to UM Specialist within 2 hours of receipt; identify duplicate requests using the claims and verify existing authorization.
Independently identifying and appropriately returning to claims or member services any file that is a duplicate to one already processed in the system; appropriately documenting what information was used in making this determination within 4 hours of receipt.
Appropriate identification and timely notification of time sensitive requests; appropriately identifying for the staff which you support, request that are priority based on date of receipt and established Turnaround Time criteria for compliance.
Accurate filing/maintenance of confidential member information.
Creating secure, complete, files.
Interface with members, medical personnel and other internal and external agencies; ensure all comply with L.A. Care requirements such as submitting requested information in a timely manner and using the approved Authorization Request form with complete medical information i.e.: ICD 10 codes, CPT, HCPC codes.
(35%)
Assist in the preparation of communication for authorization determinations, including, but not limited to preparing template letters for members and providers (authorization approval, denial, deferral, modification and pay/education).
(30%)
Assist in the technical aspects of the retrospective review process for authorizations and Member or Provider Appeals, including, but not limited to computer data entry, logging, copying, preparing of template letters for communication of appeal determinations to members, providers and partners (appeal uphold or overturn) and filing: Set up GNA files for review, log and keep track all due dates for each file.
Inform nurses of a new case received from Grievance and Appeals Specialist.; submit all Grievances and Appeals response letters to Grievances Specialist on daily basis.
(20%)
Support UM Committee and Audit activity via Department performance reporting.
Assure the accuracy of reports concerning inventory and department proficiency in maintaining regulatory standards and time frames.
(5%)
Perform other duties as assigned.
(10%)
Duties Continued
Education Required
Education Preferred
Experience
Required:
At least 6 months of health care experience.
Experience working in a cross functional work environment.
Preferred:
Experience in Medi-Cal managed care.
1 year of experience in UM/Prior Authorization.
Skills
Required:
Demonstrated proficiency in Medical Terminology required.
Strong verbal and written office communication skills.
Proficient with Microsoft Office Suite and Adobe PDF.
and
Excellent organizational, interpersonal and time management skills.
Must be detail-oriented and an enthusiastic team player.
Preferred:
Knowledge of QNXT computer systems a plus.
Knowledge of the UM patient referral process.
Knowledge of member’s health plan eligibility.
Knowledge of member’s benefits coverage.
Knowledge of Health Plan regulations.
Knowledge of HMO/UM functions.
Knowledge of ICD-10/CPT coding.
Proficient utilizing electronic medical records and documentation programs.
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
Additional Information
Required:
Weekends and holidays hours may be required, as well as OT based on a business need.
✨ Smart • Intelligent • Private • Secure
Practice for Any Interview Q&A (AI Enabled)
Predict interview Q&A (AI Supported)
Mock interview trainer (AI Supported)
Ace behavioral interviews (AI Powered)
Record interview questions (Confidential)
Master your interviews
Track your answers (Confidential)
Schedule your applications (Confidential)
Create perfect cover letters (AI Supported)
Analyze your resume (NLP Supported)
ATS compatibility check (AI Supported)
Optimize your applications (AI Supported)
O*NET Supported
O*NET Supported
O*NET Supported
O*NET Supported
O*NET Supported
European Union Recommended
Institution Recommended
Institution Recommended
Researcher Recommended
IT Savvy Recommended
Trades Recommended
O*NET Supported
Artist Recommended
Researchers Recommended
Create your account
Access your account
Create your professional profile
Preview your profile
Your saved opportunities
Reviews you've given
Companies you follow
Discover employers
O*NET Supported
Common questions answered
Help for job seekers
How matching works
Customized job suggestions
Fast application process
Manage alert settings
Understanding alerts
How we match resumes
Professional branding guide
Increase your visibility
Get verified status
Learn about our AI
How ATS ranks you
AI-powered matching
Join thousands of professionals who've advanced their careers with our platform
Unlock Your Authorization Technician Potential: Insight & Career Growth Guide
Real-time Authorization Technician Jobs Trends in Los Angeles, United States (Graphical Representation)
Explore profound insights with Expertini's real-time, in-depth analysis, showcased through the graph below. This graph displays the job market trends for Authorization Technician in Los Angeles, United States using a bar chart to represent the number of jobs available and a trend line to illustrate the trend over time. Specifically, the graph shows 151418 jobs in United States and 734 jobs in Los Angeles. This comprehensive analysis highlights market share and opportunities for professionals in Authorization Technician roles. These dynamic trends provide a better understanding of the job market landscape in these regions.
Great news! L.A. Care Health Plan is currently hiring and seeking a Authorization Technician II (12 Month Assignment) to join their team. Feel free to download the job details.
Wait no longer! Are you also interested in exploring similar jobs? Search now: Authorization Technician II (12 Month Assignment) Jobs Los Angeles.
An organization's rules and standards set how people should be treated in the office and how different situations should be handled. The work culture at L.A. Care Health Plan adheres to the cultural norms as outlined by Expertini.
The fundamental ethical values are:The average salary range for a Authorization Technician II (12 Month Assignment) Jobs United States varies, but the pay scale is rated "Standard" in Los Angeles. Salary levels may vary depending on your industry, experience, and skills. It's essential to research and negotiate effectively. We advise reading the full job specification before proceeding with the application to understand the salary package.
Key qualifications for Authorization Technician II (12 Month Assignment) typically include Information And Record Clerks and a list of qualifications and expertise as mentioned in the job specification. Be sure to check the specific job listing for detailed requirements and qualifications.
To improve your chances of getting hired for Authorization Technician II (12 Month Assignment), consider enhancing your skills. Check your CV/Résumé Score with our free Resume Scoring Tool. We have an in-built Resume Scoring tool that gives you the matching score for each job based on your CV/Résumé once it is uploaded. This can help you align your CV/Résumé according to the job requirements and enhance your skills if needed.
Here are some tips to help you prepare for and ace your job interview:
Before the Interview:To prepare for your Authorization Technician II (12 Month Assignment) interview at L.A. Care Health Plan, research the company, understand the job requirements, and practice common interview questions.
Highlight your leadership skills, achievements, and strategic thinking abilities. Be prepared to discuss your experience with HR, including your approach to meeting targets as a team player. Additionally, review the L.A. Care Health Plan's products or services and be prepared to discuss how you can contribute to their success.
By following these tips, you can increase your chances of making a positive impression and landing the job!
Setting up job alerts for Authorization Technician II (12 Month Assignment) is easy with United States Jobs Expertini. Simply visit our job alerts page here, enter your preferred job title and location, and choose how often you want to receive notifications. You'll get the latest job openings sent directly to your email for FREE!