<p>We are seeking an Insurance Verification Specialist to join a dynamic healthcare team in Los Angeles, California. This position is ideal for professionals who excel in a fast-paced medical setting and are committed to ensuring accurate and efficient patient insurance processing. The Insurance Verification Specialist plays a vital role in supporting patient access to care and helping the clinic maintain smooth, compliant operations.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Verify patient insurance coverage and eligibility with carriers for medical services.</li><li>Obtain pre-authorizations or referrals as required by insurance providers.</li><li>Accurately document insurance details and update patient records in the system.</li><li>Communicate benefit information, coverage details, or out-of-pocket requirements to patients as needed.</li><li>Collaborate with clinical and administrative staff to resolve insurance issues and support timely patient scheduling.</li><li>Assist with claim submissions by ensuring all required information is documented and filed appropriately.</li><li>Maintain strict compliance with HIPAA regulations and office confidentiality standards.</li><li>Support the front office team by answering patient or carrier questions and handling related administrative tasks.</li></ul><p><strong>Benefits:</strong> Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.</p>
<p>We are looking for a skilled Prior Authorization Specialist to support healthcare operations in Brea, California. This role involves ensuring insurance approvals for medical services, diagnostic testing, and treatments, as well as maintaining compliance with payer guidelines. As a long-term contract to hire position, this opportunity offers stability and the chance to contribute to patient care in a meaningful way.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><p>• Review clinical documentation, physician orders, and patient charts to identify insurance authorization requirements.</p><p>• Submit and track prior authorization requests for treatments, medications, procedures, and diagnostic tests.</p><p>• Verify insurance eligibility, benefits, and coverage details to ensure patients receive appropriate care.</p><p>• Act as a liaison between insurance providers, healthcare teams, and patients to communicate authorization statuses.</p><p>• Follow up on pending authorizations, addressing inquiries or resolving denials as needed.</p><p>• Maintain detailed records of approvals, denials, and supporting documentation in electronic health systems.</p><p>• Collaborate with clinical and scheduling teams to confirm services are authorized before they are provided.</p><p>• Monitor updates to payer policies and guidelines to ensure compliance with insurance requirements.</p><p>• Initiate appeals for denied authorization requests when justified.</p><p>• Uphold confidentiality standards and organizational compliance in all aspects of patient care.</p><p><br></p><p><strong>Benefits:</strong> Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.</p>
<p>We are looking for an experienced Prior Authorization Specialist to join our team in Brea, California. In this role, you will play a vital part in ensuring insurance approvals for medical services, procedures, and treatments, helping to streamline patient care and prevent claim denials. </p><p><br></p><p><strong>Key Responsibilities:</strong></p><p>• Review medical records, physician orders, and clinical documentation to identify necessary insurance authorizations.</p><p>• Submit requests for prior authorization to insurance providers for procedures, medications, and diagnostic services.</p><p>• Verify patient insurance coverage, benefits, and eligibility to prevent service interruptions.</p><p>• Communicate authorization statuses and updates to patients, healthcare providers, and insurance companies.</p><p>• Follow up on pending approvals and address issues related to payer inquiries or denials.</p><p>• Maintain detailed records of authorization outcomes and required documentation within the electronic health system.</p><p>• Collaborate with clinical and scheduling teams to ensure all approvals are in place before services are rendered.</p><p>• Monitor insurance policies and guidelines to ensure compliance with payer requirements.</p><p>• Handle appeals for denied authorization requests when necessary.</p><p>• Uphold strict confidentiality standards and organizational compliance in all interactions.</p><p><br></p><p><strong>Benefits:</strong> Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.</p>
We are looking for a highly skilled Risk Manager with extensive experience in financial services to join our team on a long-term contract basis. This role is based in Irvine, California, and involves working on strategic enterprise risk management initiatives, due diligence processes, and data analysis to support regulatory compliance and business objectives. The ideal candidate will bring expertise in risk management frameworks and consumer lending, along with a proactive approach to problem-solving.<br><br>Responsibilities:<br>• Evaluate and optimize the enterprise risk management framework, ensuring functionality and identifying areas for improvement.<br>• Perform detailed due diligence, including managing trust center operations and assigning roles within the team.<br>• Analyze existing standard reports and dissect data sets to verify accuracy and reliability.<br>• Collaborate with stakeholders to produce audit reports by gathering and structuring relevant data.<br>• Support regulatory audit examinations by providing insights and documentation to meet compliance standards.<br>• Apply auditing skills to reassess and enhance risk management practices across the organization.<br>• Develop and implement risk management strategies tailored to enterprise-level needs.<br>• Utilize data science techniques to extract actionable insights from complex data sets.<br>• Ensure that consumer lending practices align with regulatory requirements and organizational risk policies.<br>• Communicate findings and recommendations effectively to senior management and relevant teams.