Authorization Coordinator - Full Time, Day Shift

Socket.dev; Los Angeles (CA); On-site; USD 52,000 - 74,000; Full time

Job summary

Adventist Health White Memorial in Los Angeles, CA, seeks an experienced coordinator to manage prior authorizations for referrals and procedures. You will act as the primary liaison to expedite the collection process and ensure accurate billing guidance across the care pathways.

The role requires familiarity with insurance verification, CPT/ICD coding corrections, and collaboration with providers and the billing team to streamline authorization workflows.

Qualifications

• High school diploma or GED; associate/technical degree preferred.
• Experience handling prior authorizations and billing processes is preferred.
• Knowledge of CPT/ICD coding and hospital billing basics is beneficial.

Responsibilities

• Manage daily reconciliation of scheduled procedures and obtain authorizations as needed.
• Perform insurance verification prior to visits and advise on billing for procedures.
• Coordinate and synchronize authorizations with providers and hospital systems.
• Correct inaccurate CPT/ICD codes that affect pre-authorization and billing entries.
• Handle other related duties as assigned.

Skills

Prior Authorization

Insurance Verification

Billing Guidance

Education

High School Diploma or GED

Associate's/Technical Degree (Preferred)

Job description

Centered in the heart of Boyle Heights, Adventist Health White Memorial is one of the area's leading healthcare providers since 1913. We are comprised of a 353-bed hospital, three medical office buildings, residency programs, comprehensive cancer care and a vast scope of services located in the Los Angeles area. In 2019, Adventist Health White Memorial was recognized with the Malcolm Baldrige National Quality Award, the nation's highest presidential honor for performance excellence. We are proud to promote wellness in the community at the local farmers market and through our community resource center with services for seniors and Spanish-speakers. Los Angeles is known for its art, rich culture, numerous sports teams and world-renowned dining. There is something for everyone in this culturally diverse city.

Job Summary

Responsible for management of prior authorizations of all activities requiring referrals for procedures, serves as the key coordinator and liaison whose primary role is to expedite the collection process.

Education and Work Experience

• High School Education/GED or equivalent: Preferred
• Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred

Facility Specific License/Certifications

• Hospital Fire and Life Safety (HLFS): Required

Essential Functions

• Performs daily reconciliation of scheduled procedures, documenting authorization numbers obtained by others, as well as obtaining any authorizations and retroactive authorizations as needed. Serves as the coordinator for scheduled and pre-authorized procedures.
• Reconciles, updates and obtains retroactive authorizations as needed. Performs insurance verification prior to office visit procedures. Interacts with providers and staff to provide guidance and advice with regard to billing, relative to necessary procedures.
• Serves as an authoritative source to reconcile and update the authorization numbers and generate a work list of authorizations needed. Communicates with insurance providers about the patient’s medical necessity, obtain authorization for needed authorizations and reconcile to the authorization database and/or hospital systems.
• Corrects inaccurate information, CPT and ICD9 codes that prohibit pre-authorization being secured and charges being entered into billing system.
• Performs other job-related duties as assigned.

Organizational Requirements

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.