Healthcare Authorization Specialist II - UM Data & Admin

L.A. Care Health Plan; Los Angeles, Northern (CA, KY); Hybrid; USD 48,000 - 68,000; Full time

Benefits offered by this job

PTO

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Job summary

L.A. Care Health Plan in Los Angeles, CA, is seeking an Authorization Technician II to support the Utilization Management team. You will handle intake, logging, tracking and status follow-up of authorizations, ensuring timely processing and accurate documentation.

You will collect information for clinical staff, prepare template letters, and assist with retrospective reviews, referrals and appeals while maintaining confidentiality and compliance with regulatory requirements.

Qualifications

• Required: At least 6 months of health care experience.
• Experience working in a cross functional work environment.
• Preferred: Medi-Cal managed care experience.
• Preferred: 1 year of UM/Prior Authorization experience.

Responsibilities

• Process time sensitive authorization and pre-certification requests to meet department timeframes and regulatory requirements.
• Data entry and processing of referrals/authorizations in the system; maintain accurate files within defined timelines.
• Prepare template letters for authorization determinations (approval, denial, deferral, modification).
• Assist with retrospective reviews, appeals communications, and filing for Grievances/Appeals.
• Support UM Committee and Audit activity via department performance reporting.

Skills

Medical Terminology

Verbal & written communication

Organization

Time management

Detail-oriented

Team player

ICD-10/CPT knowledge

Tools

Microsoft Office Suite

Adobe PDF

Job description

L.A. Care Health Plan in Los Angeles, CA, is seeking an Authorization Technician II to support the Utilization Management team. You will handle intake, logging, tracking and status follow-up of authorizations, ensuring timely processing and accurate documentation.

You will collect information for clinical staff, prepare template letters, and assist with retrospective reviews, referrals and appeals while maintaining confidentiality and compliance with regulatory requirements.