Utilization Management Coordinator I

AltaMed • Commerce, CA

2d

About The Position

This position supports the Senior Care Services/PACE department to ensure the timeliness of outpatient or inpatient referral/authorization processing per state and federal guidelines. This position performs troubleshooting when problem situations arise and coordinates with leadership.

Requirements

• High School Diploma or equivalent required.
• Minimum 1 year of experience working in a medical billing environment (IPA or HMO preferred), with pre-authorizations and reimbursement regulations with Medi-Cal, CCS, and other government programs required.
• Prior experience working in a clinic/health care specialty call center.

Nice To Haves

• MA or Medical Billing Certificate preferred.
• Prefer experience in utilization management, processing authorization referrals.

Responsibilities

• Ensure the timeliness of outpatient or inpatient referral/authorization processing per state and federal guidelines.
• Perform troubleshooting when problem situations arise.
• Coordinate with leadership.

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: Entry Level
• Education Level: High school or GED