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

• 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