CALAIM AUTHORIZATION COORDINATOR

Libertana; Northern (KY); Hybrid; USD 33,000 - 34,000; Full time

Job summary

The CalAim Authorization Coordinator is Hybrid based in Sherman Oaks, CA, and handles intake, billing and authorizations for CalAim departments. This role supports multiple administrative tasks and requires strong communication and attention to HIPAA regulations.

Responsibilities include processing referrals, updating authorization statuses, and preparing reports while coordinating with Case Managers and external partners. A Bachelor’s degree and 2+ years in administration are preferred.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration or related field preferred.
• 2+ years of Administration experience.
• Excellent communication skills and ability to engage others.
• Proper phone etiquette.
• Experience with electronic healthcare systems.
• Experience with developing reports.
• Strong organizational and follow up skills.

Responsibilities

• Tracks and processes referrals within contract timeframes.
• Fields incoming calls and makes outgoing calls to potential members.
• Reviews intake documents for authorization submission to Health Plans.
• Tracks and updates authorization status for new members.
• Performs eligibility screening per CalAim/CCT policies.
• Coordinates with other departments for internal referrals.
• Submits authorization and reauthorization requests via MCP portals.
• Communicates CalAim services to potential members.
• Creates patient charts and uploads documents into the EMR.
• Processes approved authorizations and coordinates follow-up with Case Managers.
• Provides updates to external care partners on patient status.
• Completes CCT, CS, ECM visit logs and related integration logs.
• Assists with completing DHCS CCT forms (ITCP, FTCP, DTRF).
• Assists in CalAim MCP reporting (RTF, OTF).
• Maintains HIPAA confidentiality and complies with agency policies.
• Attends case conferences and team meetings.
• Maintains up-to-date credentials and reports Fraud and Abuse.

Skills

Communication skills

Phone etiquette

Organizational skills

Follow-up skills

HIPAA compliance

Education

Bachelor's degree in Healthcare Administration, Business Administration or related field

Tools

Microsoft Word

Microsoft Excel

Job description

# CALAIM AUTHORIZATION COORDINATORHybrid • Sherman Oaks - Sherman Oaks, CA 91411## OverviewSalary Range$24.00 - $25.00 Hourly## DescriptionPOSITION SUMMARY:The Transitions Auth Coordinator is responsible for managing the intake of new members, processing billing and authorizations, and supporting various administrative functions for the CalAim departments.ESSENTIAL DUTIES AND RESPONSIBILITIES:The following is a representation of the major duties and responsibilities of this position. The agency will make reasonable accommodations to allow otherwise qualified applicants with disabilities to perform essential functions.1. Tracks and ensures referrals are processed within the time frames stated in the CalAim/CCT contract expectations.2. Fields incoming calls and makes outgoing calls to all potential members.3. Reviews and compiles intake documents to ensure paperwork is properly completed and submitted to Health Plans for authorization4. Tracks and update authorization status for new members.5. Performs eligibility screener in compliance with CalAim/CCT policies and procedures.6. Works with other departments to identify gaps in care for members and generate internal referrals.7. Uses the different Managed Care Provider (MCP’s) portals to submit authorization and reauthorizations requests for all CalAim services.8. Has a clear understanding of services provided under CalAim (ECM and CS) and CCT with the ability to clearly communicate them to potential members.9. Creates patient charts and uploads referral and authorization documentation into the EMR system.10. Processes approved authorizations and coordinates follow up activities for Case Managers11. Provides updates to external care partners regarding patient status and/or other relevant information.12. Completes CCT, CS, ECM visit logs and works through integration logs as needed.13. Assists with completing DHCS CCT forms (ITCP, FTCP, DTRF) based on the RN assessment.14. Assists in completing weekly and monthly CalAim MCP reports on CS Communications Log, CS Return Transmission File (RTF) and ECM Return Transmission File (RTF) & ECM Outreach Transmission File (OTF).15. Conforms to all agency policies and procedures.16. Maintains/conserves confidentiality of patient and agency information always with HIPAA regulations.17. Regularly attends and participates in scheduled case conferences, staff meetings and agency in-services.18. Follows policies and procedures as per Employee Handbook.19. Maintains all required credentials up to date.20. Reports Fraud and Abuse.21. Knowledge of mandated reporting.22. Conducts timely recording and/or documentation of client contact.23. Performs other duties as assigned.## QualificationsQUALIFICATIONS:1. Bachelor's degree in Healthcare Administration, Business Administration or related field preferred.2. Has adequate computer experience in Microsoft Word and Excel.3. 2+ years of Administration experience.4. Is at least 18 years of age.5. Excellent communication skills and ability to engage others.6. Proper phone etiquette.7. Experience in working with electronic healthcare systems.8. Experience with developing reports.9. Strong organizational and follow up skillsPHYSICAL REQUIREMENTS:* Stand, sit, talk, hear, reach, stoop, kneel and use of hands and fingers to operate computer, telephone, and keyboard on a frequent basis, up to 75% of the time.* Close vision requirements due to computer work.* Light to moderate lifting may be required up to 25lbs.