Prior Authorization Specialist (Healthcare)

Socket.dev; Los Angeles (CA); On-site; USD 52,000 - 74,000; Full time

Job summary

Adventist Health White Memorial in Los Angeles, CA, seeks an experienced coordinator to manage prior authorizations for referrals and procedures. You will act as the primary liaison to expedite the collection process and ensure accurate billing guidance across the care pathways.

The role requires familiarity with insurance verification, CPT/ICD coding corrections, and collaboration with providers and the billing team to streamline authorization workflows.

Qualifications

• High school diploma or GED; associate/technical degree preferred.
• Experience handling prior authorizations and billing processes is preferred.
• Knowledge of CPT/ICD coding and hospital billing basics is beneficial.

Responsibilities

• Manage daily reconciliation of scheduled procedures and obtain authorizations as needed.
• Perform insurance verification prior to visits and advise on billing for procedures.
• Coordinate and synchronize authorizations with providers and hospital systems.
• Correct inaccurate CPT/ICD codes that affect pre-authorization and billing entries.
• Handle other related duties as assigned.

Skills

Prior Authorization

Insurance Verification

Billing Guidance

Education

High School Diploma or GED

Associate's/Technical Degree (Preferred)

Job description

Adventist Health White Memorial in Los Angeles, CA, seeks an experienced coordinator to manage prior authorizations for referrals and procedures. You will act as the primary liaison to expedite the collection process and ensure accurate billing guidance across the care pathways.

The role requires familiarity with insurance verification, CPT/ICD coding corrections, and collaboration with providers and the billing team to streamline authorization workflows.