Pre-Authorization & Utilization Specialist I

Crossfire Group; South Pasadena (CA); On-site; USD 45,000 - 48,000; Part time

Job summary

CrossFire Group in South Pasadena, CA is seeking a Pre-Authorization Specialist I for a 3-month contract. The role focuses on reviewing authorization requests, precertifications, and inpatient admission reviews to ensure appropriate utilization according to medical criteria. The position pays about $21.49 per hour.

It offers a pathway to a direct offer depending on performance. On-site work in South Pasadena, with support to healthcare providers to optimize service use and determine medical

Qualifications

• 1-3 years of relevant experience

Responsibilities

• Reviews authorization requests
• Performs utilization management activities to include precertifications, admission reviews, and retrospective authorizations, using established medical criteria.
• Supports providers in working to increase efficient utilization of services.
• Evaluates the medical necessity for inpatient hospital admission, and authorizes the admission along with the estimated length of stay.

Job description

CrossFire Group in South Pasadena, CA is seeking a Pre-Authorization Specialist I for a 3-month contract. The role focuses on reviewing authorization requests, precertifications, and inpatient admission reviews to ensure appropriate utilization according to medical criteria. The position pays about $21.49 per hour.

It offers a pathway to a direct offer depending on performance. On-site work in South Pasadena, with support to healthcare providers to optimize service use and determine medical