Position Summary

We are seeking a call Center Representative serves as the first point of contact for patients within Modena Allergy and Asthma’s central scheduling team. This role is essential in delivering a positive patient experience by providing accurate information, quick access to patient care, coordinating care, and ensuring efficient scheduling across all providers. 

This role will be based primarily in our Sorrento Valley clinic but may also provide support to other nearby locations within San Diego County. The ideal candidate is adaptable and enjoys collaborating across multiple sites to ensure seamless operations and excellent patient experiences. 

Key Responsibilities

• Serve as the primary point of contact for incoming patient calls, addressing inquiries with professionalism, courtesy, and accuracy. 

• Schedule patient appointments, diagnostic testing, and follow-up visits in collaboration with providers and clinical staff. 

• Manage patient eligibility patient check-in and check-out processes, including verifying insurance coverage and collecting co-pays. 

• Submit and track prior authorizations, ensuring all required documentation is completed and insurance requirements are met. 

• Maintain accurate, up-to-date patient records in the electronic health record (EHR) system in full compliance with HIPAA regulations. 

• Coordinate with clinical and administrative teams to support continuity of care and efficient patient flow. 

• Provide cross-coverage support as a Patient Services Representative (PSR) at clinic sites as needed, including front desk responsibilities such as patient check-in/check-out, insurance verification, and patient flow coordination. 

• Support operational needs across Modena Health locations, which may include travel to other San Diego clinics for coverage, training, or business needs. 

• Maintain flexibility in role responsibilities to support both centralized call center functions and in-clinic operations as the organization continues to grow and evolve. 

Required Qualifications: 

• High school diploma or equivalent. 

• Minimum 1 year of customer service experience 

• Strong communication and customer service skills. 

• Ability to multitask, stay organized, and work in a fast-paced environment. 

Preferred Qualifications: 

• Healthcare or medical office experience 

• Experience with scheduling systems and electronic health records (EHR). ModMed preferred. 

• Experience in handling multi-line call systems.  

• Knowledge of insurance verification and prior authorization processes. 

• Medical Assistant Certification or experience  
• 3+ years of customer service experience

Compensation

The hourly range for this position is $20.00-26.00/hour. The actual compensation for this role will be determined by a variety of factors, including but not limited to the candidate’s skills, education, and experience.

Position Summary

We are seeking a detail-oriented and proactive Prior Authorization (Buy and Bill) Specialist to join our clinic team. In this role, you will handle scheduling, inventory management, and authorization processes, while collaborating on innovative tech solutions and supporting site expansions along the Prior Authorization Manager and/or Practice Manager. This position requires strong organizational skills, knowledge of healthcare billing practices (Buy & Bill), and the ability to work in a fast-paced medical environment.

This is a full-time, non-exempt (hourly) position, scheduled for 40 hours per week. Work hours may vary based on assigned clinic location, Monday through Friday.

This role will be based primarily in our Sorrento Valley clinic but may also provide support to other nearby locations within San Diego County. The ideal candidate is adaptable and enjoys collaborating across multiple sites to ensure seamless operations and excellent patient experiences.

Key Responsibilities

• Call insurance companies to verify coverage (PPO and HMO), obtain benefit details, and confirm authorization requirements.
• Submit, track, and manage prior authorizations in a timely manner, ensuring documentation meets payer and clinical requirements.
• Coordinate with clinics and Practice Managers to align on injection and medication timelines, patient scheduling, and clinical administration.
• Schedule appointments and times for patients to receive their medications, coordinating with clinical staff to ensure timely and appropriate administration.
• Track medication inventory levels, monitor stock to prevent shortages, and initiate purchasing orders as needed to maintain adequate supplies.
• Monitor reimbursement and billing success rates, analyze denials or discrepancies, and collaborate with billing teams to resolve issues and improve collection processes.
• Implement checks to prevent patients from receiving medications too early, adhering to prescribed intervals and regulatory guidelines.
• Verify that all necessary authorizations are in place prior to medication administration, minimizing risks of non-reimbursement or compliance violations.

A Typical Day May Include

• Calling payers, submitting new and renewal prior authorizations, and following up to ensure timely approvals.
• Updating patient notes and EHR records to reflect authorization status and next steps.
• Coordinating with clinics and patients to manage scheduling, follow-ups, and re-authorizations.
• Communicating with pharmacies to confirm shipments and ensure medications are delivered on time.
• Monitoring injection timelines to prevent care delays and authorization lapses.

Qualifications & Requirements

• Education: Bachelor's degree in healthcare administration, business, or related field preferred
• Experience:  
  • 2+ years of experience in healthcare administration, medical billing, or inventory management, with familiarity in buy-and-bill processes for medications.
  • Relevant certifications (e.g., Certified Medical Assistant or Billing Specialist) preferred.
  • Medical or medical assistant background strongly preferred.
  • Strong understanding of insurance prior authorizations, reimbursement policies, and healthcare compliance regulations (e.g., HIPAA, Medicare/Medicaid guidelines).
  • Proficiency in medical software systems, inventory management tools, and Microsoft Office Suite; experience with automation or tech integration projects is a plus
• Skills & Abilities:
  • Excellent organizational and multitasking skills, with the ability to prioritize tasks in a dynamic environment.
  • Strong communication and negotiation abilities for working with vendors, tech partners, insurers, and internal teams.
  • Attention to detail and problem-solving mindset to handle complex billing and authorization scenarios.
  • Ability to work independently and collaboratively in a team-oriented settings.

Compensation

The hourly range for this position is $22.00-30.00/hour. The actual compensation for this role will be determined by a variety of factors, including but not limited to the candidate’s skills, education, and experience.

Position Summary

We are seeking a highly skilled and compassionate Allergist/Immunologist Physician to join our growing practice in Greater San Diego, Greater South Bay LA, & New Prospect Locations. As a key member of our healthcare team, you will be responsible for diagnosing and treating patients with a wide range of allergic and immunologic conditions. You will provide high-quality care, collaborate with other medical professionals, and have the opportunity to work in a patient-centered, multidisciplinary environment.

The ideal candidate must be a self-motivated and eager individual who will establish him/herself in a practice that enjoys continuous growth. Must have excellent communication skills, bedside manner, and a strong work ethic with a desire to be part of a team that is committed to caring for the whole patient. We place special emphasis on providing patient-centered care, quality outcomes and patient satisfaction. If you are a dedicated and caring Allergist/Immunologist with an interest in advancing the field through clinical research and looking to make a difference in the lives of patients, we encourage you to apply. This is a unique opportunity to shape the future of allergy and immunology care while contributing to groundbreaking research in a collaborative and supportive environment. This role is exempt (salary) and full-time, working 40 hours per week, Monday through Friday with minimal travel. 

Key Responsibilities

• Clinical Responsibilities
  • Diagnose, treat, and manage patients with allergies, asthma, immunologic conditions, and related diseases.
  • Conduct comprehensive patient evaluations, including medical history, physical exams, and appropriate diagnostic tests (e.g., skin tests, blood tests, pulmonary function tests).
  • Develop and implement individualized treatment plans, including medication management, immunotherapy, and lifestyle modifications.
  • Educate patients and their families about managing allergies, asthma, and immunologic conditions.
  • Perform procedures such as allergy skin testing, spirometry, and immunotherapy (allergy shots).
  • Oversee in-office oral food challenges, drug challenges, and immunotherapy treatments (oral immunotherapy and sublingual immunotherapy for environmental and food allergy)
  • Develop and implement individualized care plans based on patient needs and medical history, including:
  • Starting allergy immunotherapy for environmental allergies
  • Starting oral immunotherapy for food allergy
  • Recommending food or drug challenges as part of allergy evaluation
  • Collaborate with other specialists (e.g., pulmonologists, dermatologists, primary care physicians) to ensure comprehensive care for patients.
  • Maintain accurate and up-to-date medical records in compliance with healthcare regulations and confidentiality standards.
  • Stay informed about the latest advancements in allergy and immunology treatments and participate in continuing medical education (CME).
  • Ensure high patient satisfaction and provide empathetic care, focusing on patient education and wellness.
  • Additional duties as assigned. 
• Research Responsibilities
  • Engage in clinical research initiatives through Orso Health, Modena Health’s research arm, related to the diagnosis, treatment, and prevention of allergic and immunologic diseases, or other areas of clinical interest.
  • Participate in designing and conducting clinical trials, including trials on new therapies, biologic treatments, and immunotherapy options.
  • Analyze data, prepare research reports, and collaborate with research teams to publish findings in medical journals.
  • Contribute to the development of innovative clinical pathways and treatment strategies based on research findings.
  • Work closely with industry partners, academic institutions, and research foundations to advance clinical studies in allergy and immunology.
  • Provide mentorship and guidance to junior researchers interested in allergy and immunology research.
  • Present research findings at national and international conferences.
  • Additional duties as assigned.

Qualifications & Requirements

• Education
  • Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited medical school.
• Experience
  • Completion of an accredited residency in Internal Medicine or Pediatrics.
  • Successful completion of a fellowship in Allergy and Immunology.
  • Board certified or board eligible in Allergy and Immunology.
  • 1–3 years of post-fellowship clinical experience preferred; will consider highly qualified new fellowship graduates.
  • Demonstrated experience in diagnosing and managing patients with allergies, asthma, and immunologic conditions.
  • Hands-on experience performing and interpreting allergy testing, spirometry, and administering immunotherapy
• Licensure & Certifications
  • Board certification or eligibility in Allergy and Immunology (ABAI).
  • Valid and unrestricted medical license to practice in California.
• Skills & Abilities
  • Strong knowledge of allergy, asthma, and immunologic diseases and treatments.
  • Interest and experience in clinical research, including trial design and data analysis.
  • Excellent communication and interpersonal skills, with the ability to build rapport with patients and their families.
  • Ability to work effectively both independently and as part of a collaborative healthcare team.
  • Compassionate and patient-centered approach to care.
• Preferred Qualifications
  • Experience in a clinical or private practice setting.
  • Bilingual in Spanish (preferred but not required).
  • Expertise in immunotherapy and biologic treatments for allergy and asthma.
  • Experience in writing research protocols, grant submissions, or publishing research.
  • Interest in exploring innovative treatments and contributing to the advancement of immunology.

Compensation

The annual salary range for this position in California is $130,000-250,000/year. The actual compensation for this role will be determined by a variety of factors, including but not limited to the candidate’s skills, education, and experience.