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Home Based Prior Authorization Jobs in California

MedImpact

Prior Authorization Coordinator I

San Diego, CA · On-site

$19.75 - $24.50/hr

Prior Authorization Specialist Works as a member of the Prior Authorization Operations team ... Extent of supervision ranges from close, to moderate, to minimal oversight based upon demonstrated ...

MedImpact

Prior Authorization Coordinator I

San Diego, CA · On-site +1

$22.55 - $27.41/hr

Processes prior authorization requests in accordance with standards for accuracy, timeliness ... Extent of supervision ranges from close, to moderate, to minimal oversight based upon demonstrated ...

OPN Healthcare

Be Seen First

Prior Authorization & Referral Coordinator

Glendale, CA · On-site

$18 - $22/hr

Determine the need for prior authorization based on insurance guidelines and verify patient eligibility. * Medical Records Review: Compile necessary medical documentation for prior authorization ...

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Home Based Prior Authorization information

What is a home based prior authorization specialist?

A Home Based Prior Authorization specialist is a healthcare professional who works remotely to review and process prior authorization requests for medical procedures, medications, or services. Their main role is to ensure that treatments and prescriptions meet insurance requirements before approval, helping patients receive necessary care while managing costs for providers and insurers. These specialists communicate with healthcare providers, insurance companies, and sometimes patients, using secure online systems to perform their duties from home. Their work is critical in streamlining healthcare access and preventing unnecessary delays in treatment.

What are the key skills and qualifications needed to thrive as a home based prior authorization specialist?

To thrive as a Home Based Prior Authorization Specialist, you need a solid understanding of medical terminology, insurance policies, and healthcare procedures, often supported by experience in medical billing or coding. Familiarity with electronic health record (EHR) systems, payer portals, and prior authorization software is typically required, along with certifications like CPC or CPB being advantageous. Strong attention to detail, effective communication, and the ability to work independently are valuable soft skills in this remote role. These competencies ensure timely and accurate authorization processing, reduce claim denials, and support seamless patient care coordination.

What are some common challenges faced in a home based prior authorization role and how can they be managed?

One common challenge in a home-based prior authorization role is maintaining effective communication with healthcare providers and insurance companies while working remotely. This can be managed by utilizing secure digital communication tools and staying organized with thorough documentation. Another challenge is staying updated on frequently changing insurance policies and regulations, which can be addressed by participating in ongoing training and regularly reviewing updates from payers. Additionally, managing distractions and maintaining productivity at home requires setting a dedicated workspace and a structured daily routine.

What is the difference between Home Based Prior Authorization vs Medical Coder?

AspectHome Based Prior AuthorizationMedical Coder
CredentialsTypically requires healthcare experience, knowledge of insurance policies, and sometimes certifications in healthcare administrationRequires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentRemote, healthcare or insurance company settingRemote or on-site, healthcare facility or billing office
Industry UsageUsed in insurance, healthcare administration, and utilization reviewUsed in medical billing, coding, and health information management

Home Based Prior Authorization specialists focus on reviewing and approving insurance requests for medical procedures, requiring healthcare knowledge. Medical Coders translate medical records into codes for billing, requiring coding certifications. While both roles are remote and healthcare-related, they serve different functions within the healthcare industry.

What are the most commonly searched types of Prior Authorization jobs in California?

The most popular types of Prior Authorization jobs in California are:

What are popular job titles related to Home Based Prior Authorization jobs in California?

For Home Based Prior Authorization jobs in California, the most frequently searched job titles are:

What job categories do people searching Home Based Prior Authorization jobs in California look for?

The top searched job categories for Home Based Prior Authorization jobs in California are:

What cities in California are hiring for Home Based Prior Authorization jobs?

Cities in California with the most Home Based Prior Authorization job openings:

Home Based Prior Authorization jobs near you
Infographic showing various Home Based Prior Authorization job openings in California as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 17% Part Time, and 8% Contract. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution.

Prior Authorization Coordinator

Los Angeles, CA • On-site

University of California

8.5

Company rating: 8.5 out of 10

Based on 34 frontline employees who took The Breakroom Quiz

82nd of 625 rated colleges and universities

Great coworkers

People enjoy working here

Good employer

Learn more about University of Californiaexternal

$30.36 - $43.49/hr

Other

This job post has expired 4 days ago. Applications are no longer accepted.

Job description

Description

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: $30.36 - $43.49/hour

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.

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