Healthcare Authorization & Compliance Specialist

CommonSpirit Health; Woodland (CA); Vor Ort; USD 55.000 - 85.000; Vollzeit

Zusammenfassung

Dignity Health Medical Foundation seeks an Authorization Specialist to protect compliance and financial integrity across the facility. You will audit financial records and internal controls, identify risks, and provide actionable recommendations to improve performance while ensuring adherence to healthcare laws.

The role requires strong analytical skills, attention to detail, and the ability to clearly communicate findings to diverse stakeholders.

Qualifikationen

• Audits financial records, processes and regulatory compliance.
• Identify risks and evaluate internal controls to enhance performance.
• Communicate complex findings persuasively to drive improvements.

Aufgaben

• Keep accurate records in EMR/practice management systems and manual filings.
• Obtain internal and external prior authorizations for insurance carriers and schedule patient appointments.
• Interface with provider office staff to obtain information for authorization approval.
• Screen for Advanced Beneficiary Notice as needed for services referred to other departments.
• Collaborate with billing staff to maximize reimbursement through appeals.

Kenntnisse

Auditing

Healthcare regulations

Communication

Attention to detail

Independent work

Ausbildung

High School Diploma or GED

Tools

EMR system

Practice management system

Windows OS

Jobbeschreibung

Dignity Health Medical Foundation seeks an Authorization Specialist to protect compliance and financial integrity across the facility. You will audit financial records and internal controls, identify risks, and provide actionable recommendations to improve performance while ensuring adherence to healthcare laws.

The role requires strong analytical skills, attention to detail, and the ability to clearly communicate findings to diverse stakeholders.