Admissions & Utilization Coordinator

Loma Linda University Health; Loma Linda (CA); Presencial; USD 65.000 - 85.000; Jornada completa

Descripción de la vacante

Loma Linda University Health is seeking a Coordinator for Utilization Management/Review to support admission and transfer operations across LLUMC, Surgical Hospital, East Campus, and Children's Hospital. You will manage intake calls, coordinate with transferring physicians, and interface with payers and the PBO for eligibility and payer sources.

The role requires a high school diploma (or GED) and at least three years in medical group/UM/hospital admitting settings, with HIPAA knowledge and

Formación

• High school diploma or GED required.
• Minimum of three years of experience with a medical group, managed care organization, utilization management, hospital admitting or medical nursing unit.
• Basic knowledge of medical terminology, HIPAA and patient rights.
• Working knowledge of healthcare insurances and health plans.
• Read/write English; Spanish preferred; communicate professionally; work with minimal supervision; meet deadlines; use computer/software.
• Nationally recognized certification in Utilization Management, Utilization Review, Hospital Utilization Review or Managed Care preferred.

Responsabilidades

• Coordinate and monitor admissions and transfers to LLUMC and affiliated hospitals.
• Process intake calls for ED to ED transfers and interfacility transfers.
• Collaborate with payers and PBO on eligibility and payer sources.
• Assist in daily operations of Patient Placement Services with minimal supervision.

Conocimientos

Bilingual English/Spanish

Clinical coordination

Interdepartmental communication

Problem solving

Educación

High school diploma or GED

Descripción del empleo

Loma Linda University Health is seeking a Coordinator for Utilization Management/Review to support admission and transfer operations across LLUMC, Surgical Hospital, East Campus, and Children's Hospital. You will manage intake calls, coordinate with transferring physicians, and interface with payers and the PBO for eligibility and payer sources.

The role requires a high school diploma (or GED) and at least three years in medical group/UM/hospital admitting settings, with HIPAA knowledge and