Job Description

Job Location: 5643 Copley Drive Ste 240 - San Diego , CA 92111
Salary Range: $21.00 - $25.00 Hourly

Prior Authorization & Insurance Coordination:
- Verify insurance eligibility, benefits, and payer requirements for sleep-related services
- Obtain and manage prior authorizations/pre-certifications for:
- - Home Sleep Apnea Testing (HSAT)
- - In-Lab Sleep Studies (Polysomnography)
- - CPAP/BiPAP titration studies
- - Durable Medical Equipment (DME), PAP devices, and supplies
- - Follow-up visits and specialty referrals as needed
- Submit medical records and clinical documentation to insurance carriers
- Monitor authorization approvals, denials, renewals, and expiration dates
- Coordinate peer-to-peer reviews, appeals, and denial resolutions
- Communicate authorization status and financial responsibility to patients
Medical Assistant Duties:
- Room patients and obtain vital signs, medical history, medication reconciliation, and sleep-related symptom updates
- Prepare patients for provider visits, consultations, and follow-up appointments
- Assist providers with examinations, procedures, and patient education
- Educate patients on sleep study preparation, CPAP/BiPAP compliance, and treatment plans
- Process prescription refills, DME orders, and provider documentation
- Maintain exam rooms, supplies, and clinical equipment
- Support scheduling and coordination of sleep studies and follow-up appointments

Qualifications
- High school diploma or equivalent required
- Medical Assistant certification preferred (CMA, RMA, or equivalent per state requirements)
- 1–3 years of prior authorization, medical assistant, or sleep medicine experience preferred
- Knowledge of insurance verification, CPT/ICD-10 coding, and payer portals
- Familiarity with sleep medicine, pulmonology, neurology, or DME processes preferred
- CPR/BLS certification preferred