Medical Authorization & Eligibility Specialist

Cffhae; California; Hybrid; USD 44,000 - 50,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Retirement

PTO

Job summary

CFHE currently seeks an Authorization Coordinator for our Pediatric Clinic in Panorama City, CA. The role focuses on obtaining authorizations and conducting utilization reviews across multiple locations to ensure timely coverage for patients.

You will verify eligibility, coordinate benefits, and address patient questions while maintaining accurate records and reporting to the Clinic Manager.

Qualifications

• Must have 2+ years in a medical office environment.
• Experience handling authorizations and referrals is required.
• Proficient with electronic health records and medical databases.
• Knowledge of CPT codes and common insurances (Medi-Cal/HMO/PPO).
• Excellent telephone and oral communication skills.

Responsibilities

• Verify eligibility with insurers and request authorizations/referrals.
• Contact primary care physicians for required information.
• Follow up with authorization departments to obtain approvals promptly.
• Create charts and upload authorizations and referrals.
• Report delays to management and monitor daily authorization reports.
• Notify patients by phone about approvals or denials and log events.
• Enter data into authorization software accurately.
• Educate referring providers on processes and documentation.
• Perform other duties as assigned.

Skills

Medical office experience

Authorization processing

EHR proficiency

CPT coding knowledge

Phone communication

Education

High School Diploma or GED

2 years in medical office

Job description

CFHE currently seeks an Authorization Coordinator for our Pediatric Clinic in Panorama City, CA. The role focuses on obtaining authorizations and conducting utilization reviews across multiple locations to ensure timely coverage for patients.

You will verify eligibility, coordinate benefits, and address patient questions while maintaining accurate records and reporting to the Clinic Manager.