Northridge, CA, 91329, USA
1 day ago
Prior Authorizations Representative
Position Summary The Prior Authorization Coordinator plays a critical role in ensuring timely and appropriate access to care by efficiently processing prior authorization requests. This position requires a strong understanding of utilization management policies and a commitment to accuracy, compliance, and patient-centered service. Key ResponsibilitiesPrior Authorization Processing + Manage incoming prior authorization requests from providers, patients, and internal departments. + Verify member eligibility and benefits. + Collect and review necessary clinical documentation to support authorization decisions. Quality Assurance & Compliance + Maintain compliance with regulatory and organizational turnaround time standards. + Ensure accuracy and completeness in all authorization processing. + Identify and escalate potential issues or discrepancies in documentation or eligibility. Patient & Provider Communication + Communicate clearly and professionally with patients regarding the status of their authorization requests. + Provide guidance and clarification to providers and internal stakeholders as needed. Required Skills & Competencies + Risk Management + Electronic Medical Records (EMR) + Project Coordination + Care Coordination Preferred Qualifications + 2+ years of experience in prior authorization or utilization management. + Strong organizational skills and attention to detail. + Excellent verbal and written communication skills. + Ability to manage multiple priorities in a fast-paced environment. + Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint). + Familiarity with healthcare and managed care principles. + Experience planning and coordinating job fairs or similar events is a plus. + High school diploma or equivalent required; Associate’s degree preferred. + Demonstrated ability to handle confidential information in compliance with HIPAA regulations. Pay and Benefits The pay range for this position is $25.00 - $25.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Northridge,CA 91324. Application Deadline This position is anticipated to close on Jun 11, 2025. About TEKsystems and TEKsystems Global Services We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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