Referrals Specialist II

AltaMed • Los Angeles, CA

1d

About The Position

The Specialist, Referral II, is responsible for providing support to the Medical Management and inter-departmental staff and assisting providers and members/patients with the referral process and status questions and as a resource for patients, providers, staff, and external customers regarding authorizations and third-party reimbursement policies as well as facilitating processing of most complex issues with patients and third-party payer issues.

Requirements

• High school diploma required
• Minimum of 2 years’ experience working in a medical billing environment (IPA or HMO preferred)
• Experience with pre-authorizations and reimbursement regulations on Medi-Cal, CCS, and other government programs required
• Prior Utilization Management Experience is also required

Nice To Haves

• Medical Assistant Certificate or Medical Billing Certificate preferred
• Prior Lead position experience
• Bilingual English/Spanish preferred

Responsibilities

• Providing support to the Medical Management and inter-departmental staff
• Assisting providers and members/patients with the referral process and status questions
• Acting as a resource for patients, providers, staff, and external customers regarding authorizations and third-party reimbursement policies
• Facilitating processing of most complex issues with patients and third-party payer issues

Benefits

• Medical, Dental and Vision insurance
• 403(b) Retirement savings plans with employer matching contributions
• Flexible Spending Accounts
• Commuter Flexible Spending
• Career Advancement & Development opportunities
• Paid Time Off & Holidays
• Paid CME Days
• Malpractice insurance and tail coverage
• Tuition Reimbursement Program
• Corporate Employee Discounts
• Employee Referral Bonus Program
• Pet Care Insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED