Authorization Coordinator - Remote - 137237

UC San Diego Health's Revenue Cycle department supports the organization's mission to deliver outstanding patient care and to create a healthier world - one life at a time. We are a diverse, patient-focused, high-performing team with a commitment to quality, collaboration, and continuous improvement that enables us to deliver the maximum standard of care to our patients. We offer challenging career opportunities in a fast-paced and innovative environment and we embrace individuals who demonstrate a deep passion for problem-solving and customer service.

Investigates highly complex claims, evaluate funding sources for patients in need, and propose procedures and systems in support of efficient workflows and maximization of reimbursement.

Required Specialties:

• Insurance Authorization & Reimbursement Management: Expertise in insurance billing and collections, including third-party insurance, government programs (Medicare, Medicaid), and physician billing.
• Financial Counseling & Accounts Receivable Management: Knowledge of financial counseling, cash posting, and managing the full lifecycle of accounts receivable to secure collections.
• Compliance & Regulatory Knowledge: Proficient understanding of healthcare regulations, billing, and collections requirements, ensuring adherence to both internal policies and external agency guidelines.
• Claims Investigation & Resolution: Experience handling complex claims, resolving discrepancies, and identifying alternative funding sources for patients in need.
• System & Workflow Optimization: Ability to evaluate and propose improvements to current systems and workflows, aiming to maximize reimbursement and efficiency.
• Customer Service Delivery Models: Skilled in developing and maintaining customer service models that align with patient and insurance provider needs, ensuring clear and efficient communication.

• Seven (7) years of related experience, education/training, OR a Bachelor's degree in related area plus three years of related experience/training. Related experience: Registration and Authorization submission.

• Experience and prove success in billing and/or collections processes, concepts, systems and external regulations.

• Knowledge of medical terminology and coding.

• CRCR Certified Revenue Cycle Representative.

• Experience in Infusion treatment authorization.

• Strong knowledge of EPIC and Insurance Payer portals.

• Must be able to work various hours and locations based on business needs.

• Employment is subject to a criminal background check and pre-employment physical.