Utilization Management Coordinator I
Location :
Los Angeles, CA
Job Type :
Temp/Contract
Reference Code :
Montebello
Required Years of Experience :
1 - 2 Years
Required Education :
High school Diploma or GED
Job Industry :
Healthcare - Health Services
Job Description :
-
Location: Los Angeles, CA
Schedule: Full Time / Hours between 8am & 5pm.
Pay: $23 - $26 - Depending on Experience
Job Type: Temporary Assignment
Job Summary:
This position is responsible for providing support to the Medical Management department to ensure timeliness of outpatient or inpatient referral/authorization processing per state and federal guidelines. This position performs trouble-shooting when problems situations arise and coordinates with leadership.
Key Responsibilities:
- Input data into the Medical Management system to ensure timeliness of referral/authorization processing.
- Coordinates and assists with patient appointments as needed and notify patient of authorization status.
Work Environment:
- Work is in an office environment, climate controlled through central air conditioning.
- May have some exposure to outside environments while traveling.
Required Skills and Abilities:
- Ability to sit, stand, stoop, reach, lift (up to 10 pounds), bend, etc. hand and wrist dexterity to utilize computer/ and telephones.
- Knowledge of medical terminology and coding (e.g., ICD-10, CPT, HCPCS)
- Knowledge of HIPAA Guidelines including the PHI privacy requirements
Required Qualifications :
Specifications:
-
- MA or Medical Billing Certificate preferred.
- Minimum 1 year of experience working in a medical billing environment (IPA or HMO preferred), with pre-authorizations and reimbursement regulations pertaining to Medi-Cal, CCS and other government programs required.
- Prior experience working in a clinic/health care specialty call center.
- Prefer experience in utilization management processing authorization referrals
Experience:
1 year of UM experience and knowledgeable with cpt codes and medical terminology