Prior Authorization Specialist for Senior Care

All Seniors Foundation; Alhambra (CA); On-site; USD 48,000 - 70,000; Full time

Benefits offered by this job

Health, dental, vision

401(k)

Paid training

Daytime schedule

Quiet work environment

Job summary

All Seniors Foundation in Los Angeles, CA, is seeking an Insurance Authorization Specialist to obtain prior authorizations from Medi-Cal, Medicare Advantage plans, and commercial payers so seniors receive needed care without billing surprises.

You will work upstream of clinical visits, submitting requests, verifying benefits, documenting in our EHR, and communicating with payer case managers to expedite approvals. This is a full-time role with benefits.

Qualifications

• 2+ years of prior-authorization or insurance verification experience.
• Familiarity with Medi-Cal, Medicare Advantage, and major commercial payers.
• Knowledge of ICD-10, CPT, and HCPCS codes.
• Strong telephone communication and persistence with payer call centers.
• High school diploma; relevant certificate or associate’s preferred.

Responsibilities

• Submit prior authorization requests for home health, hospice, DME, and outpatient services
• Verify insurance eligibility and benefits before scheduled care begins
• Communicate with payer case managers to expedite approvals
• Document authorization numbers, expiration dates, and visit limits in our EHR
• Follow up on denied or delayed authorizations including peer-to-peer reviews
• Educate clinical staff on payer-specific authorization requirements

Skills

Prior-authorization

Insurance verification

Medi-Cal familiarity

Medicare Advantage familiarity

ICD-10 knowledge

CPT knowledge

HCPCS knowledge

Phone communication

Persistence with payers

Education

High school diploma

Associate’s or certificate preferred

Job description

All Seniors Foundation in Los Angeles, CA, is seeking an Insurance Authorization Specialist to obtain prior authorizations from Medi-Cal, Medicare Advantage plans, and commercial payers so seniors receive needed care without billing surprises.

You will work upstream of clinical visits, submitting requests, verifying benefits, documenting in our EHR, and communicating with payer case managers to expedite approvals. This is a full-time role with benefits.