Medical Assistant- Authorization Coordinator 24-00719
Alura Workforce Solutions
Date: 2 weeks ago
City: Rancho Cucamonga, CA
Contract type: Full time
Position
Coordinator- Utilization Management Outpatient
Description
Under the general direction of the UM Outpatient Manager and Supervisor, the Outpatient UM Coordinator, is a high paced position that requires timely processing of authorization requests, verifying eligibility and obtaining additional information as requested by Medical Management or Utilization Management Nurses. This position requires that one be organized, ability to multitask with a working knowledge of ICD.9/10, CPT Coding and Medical Terminology. The Outpatient UM Coordinator will also ensure that provider calls are responded to in an accurate and timely manner while always maintaining the highest level of customer service.
Responsible for monitoring the Right Fax Server. Ensuring all referrals are processed in a timely manner and ensuring compliance with appropriate turnaround timeframes.
Responsible for checking the referral form for completeness, obtaining missing demographic information as needed, and initial attempts at coding any uncoded referrals.
Responsible for meeting accuracy standards for appropriate authorizations of referrals at the UM Coordinator level.
Responsible for representing the Inland Empire Health Plan in a friendly and professional manner while answering the calls for the Utilization Management Department.
Communicate with providers in consultation with the Utilization Management Nurse, regarding authorizations, modifications, denials, and other matters pertinent to processing authorization requests or other UM related correspondence.
Assist Management or Utilization Management Nurses as requested.
Requirements
Minimum of three (3) years of experience as a data entry specialist or coordinator.
Experience as a data entry specialist or coordinator preferably in an HMO or Managed Care setting.
High school diploma or GED required.
Associate's degree or Bachelor's degree from an accredited institution preferred.
Medical Assistant certificate preferred.
Requires knowledge of ICD-9/10 and CPT codes. Managed Care or physician office a must.
Skilled in computer applications, including word processing, database, and spreadsheets. Good customer service skills.
INDH
Coordinator- Utilization Management Outpatient
Description
Under the general direction of the UM Outpatient Manager and Supervisor, the Outpatient UM Coordinator, is a high paced position that requires timely processing of authorization requests, verifying eligibility and obtaining additional information as requested by Medical Management or Utilization Management Nurses. This position requires that one be organized, ability to multitask with a working knowledge of ICD.9/10, CPT Coding and Medical Terminology. The Outpatient UM Coordinator will also ensure that provider calls are responded to in an accurate and timely manner while always maintaining the highest level of customer service.
Responsible for monitoring the Right Fax Server. Ensuring all referrals are processed in a timely manner and ensuring compliance with appropriate turnaround timeframes.
Responsible for checking the referral form for completeness, obtaining missing demographic information as needed, and initial attempts at coding any uncoded referrals.
Responsible for meeting accuracy standards for appropriate authorizations of referrals at the UM Coordinator level.
Responsible for representing the Inland Empire Health Plan in a friendly and professional manner while answering the calls for the Utilization Management Department.
Communicate with providers in consultation with the Utilization Management Nurse, regarding authorizations, modifications, denials, and other matters pertinent to processing authorization requests or other UM related correspondence.
Assist Management or Utilization Management Nurses as requested.
Requirements
Minimum of three (3) years of experience as a data entry specialist or coordinator.
Experience as a data entry specialist or coordinator preferably in an HMO or Managed Care setting.
High school diploma or GED required.
Associate's degree or Bachelor's degree from an accredited institution preferred.
Medical Assistant certificate preferred.
Requires knowledge of ICD-9/10 and CPT codes. Managed Care or physician office a must.
Skilled in computer applications, including word processing, database, and spreadsheets. Good customer service skills.
INDH
How to apply
To apply for this job you need to authorize on our website. If you don't have an account yet, please register.
Post a resumeSimilar jobs
Manager, Domain Data Services
IEHP,
Rancho Cucamonga, CA
5 days ago
What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!The manager of Domain data services is a dynamic leader spearheading innovation in data and analytics. They collaborate with business units, and analytics. They collaborate with...
Electrical Engineer
LEAF Engineers,
Rancho Cucamonga, CA
$89,888
-
$134,832
per year
1 week ago
LEAF Engineers is a frontrunner for success in providing comprehensive mechanical, electrical and plumbing, technology, and fire protection engineering design services. Our engineers are focused on system performance, reliability, flexibility, and ease of maintenance. Our work typically consists of large commercial projects, primarily award-winning K-12 schools. With an emphasis on teamwork, we reach beyond the traditional MEP approach to solve...
CA Senior Claims Specialist
CorVel Corporation,
Rancho Cucamonga, CA
$28.02
-
$45.13
per hour
3 weeks ago
The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim, supporting the goals of claims department...
