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General Information

Work Location: Los Angeles, USA
Onsite or Remote
Flexible Hybrid
Work Schedule
Monday - Friday, 8:30am - 5:30pm PST
Posted Date
04/21/2025
Salary Range: $29.42 - 42.14 Hourly
Employment Type
2 - Staff: Career
Duration
Indefinite
Job #
23781

Primary Duties and Responsibilities

Take on an important role within an award-winning health organization. Help ensure the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health.

 

You will receive urgent, routine, pre-service, and retro authorization requests, as well as process prior authorization requests with accuracy and timeliness.  This will involve the use of various business applications to perform analysis, obtain information, and enter prior authorization data necessary for claims adjudication. You will use your critical thinking skills to identify missing information and make prior authorization processing determinations based on clinical protocols and other guidelines. You will also interact with internal and external customers to provide and obtain information and ensure the delivery of outstanding service and quality.

 

Salary Range: $29.42-$42.14/hour

Job Qualifications

We’re seeking a self-motivated, team-oriented professional with:
  • High school diploma, GED or equivalent experience
  • One or more years of experience working in a managed care environment preferred 
  • Experience processing ambulatory commercial, Medicare Fee for Service, Medicare Advantage prior authorizations a plus
  • Knowledge of the HMO referral process, eligibility verification, and health plan benefit interpretation desired
  • Strong communication, organizational, critical thinking, and problem-solving skills
  • Ability to work effectively across functional areas of the company
  • Excellent execution and follow-up abilities
  • Computer proficiency with Microsoft Office
  • Ability to multi-task, work with frequent interruptions, and meet deadlines
  • Detailed and goal orientation
  • Ability to cope well with ambiguity and stressful situations
  • Ability to maintain confidentiality of patient and business records
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 250 community clinics throughout Southern California. We are also home to the David Geffen School of Medicine, a highly respected leader in the development of breakthrough medical research and outstanding clinical professionals. If you’re looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.

As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.