Coordinator II, Utilization Management

AltaMed Health Services; Montebello (CA); Hybrid; USD 37,084 - 46,356; Full time

Benefits offered by this job

Medical, dental, vision

403(b) Retirement plan

Paid Time Off & Holidays

CME days

Tuition reimbursement

Employee discounts

Referral bonus

Tail coverage

Job summary

AltaMed Health Services in Montebello, CA is seeking a Coordinator II, Utilization Management to support the Medical Management department in timely referral/authorization processing per state and federal guidelines. The role involves troubleshooting and taking independent action to resolve complex issues.

Minimum requirements include a High School Diploma, 2+ years in medical billing (Medi-Cal/ CCS knowledge a plus), and experience in utilization management and pre-authorizations.

Qualifications

• High School Diploma or equivalent required.
• MA or Medical Billing Certificate preferred.
• Minimum 2 years of experience working in a medical billing environment (IPA or HMO preferred).
• Experience with pre-authorizations and reimbursement regulations (Medi-Cal, CCS, etc.).
• Experience in utilization management and processing authorization referrals.

Responsibilities

• Support Medical Management to ensure timely referral/authorization processing per guidelines.
• Troubleshoot and resolve complex issues in the authorization workflow.
• Collaborate with teams to maintain regulatory compliance and efficiency.

Skills

Utilization management

Medical billing

Pre-authorizations

Education

High School Diploma

Medical Billing Certificate

Job description

Position Title: Coordinator II, Utilization Management

Location: Montebello, CA 90640

Description:

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day.

Job Overview

This Coordinator II of Utilization Management is responsible for providing support to the Medical Management department to ensure the timeliness of outpatient or inpatient referral/authorization processing per state and federal guidelines. This position performs troubleshooting when problem situations arise and takes independent action to resolve complex issues.

Minimum Requirements

• High School Diploma or equivalent required.
• MA or Medical Billing Certificate preferred.
• Minimum 2 years of experience working in a medical billing environment (IPA or HMO preferred), with pre-authorizations and reimbursement regulations about Medi-Cal, CCS, and other government programs required.
• Prior experience in utilization management, processing authorization referrals is also required.
• Prefer prior Lead position experience.

Compensation

$26.92 - $33.65 hourly

Compensation Disclaimer

Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

Benefits & Career Development

• Medical, Dental and Vision insurance
• 403(b) Retirement savings plans with employer matching contributions
• Flexible Spending Accounts
• Commuter Flexible Spending
• Career Advancement & Development opportunities
• Paid Time Off & Holidays
• Paid CME Days
• Malpractice insurance and tail coverage
• Tuition Reimbursement Program
• Corporate Employee Discounts
• Employee Referral Bonus Program
• Pet Care Insurance

Job Advertisement & Application Compliance Statement

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

Remote Type: Hybrid

About US:

As the nation's largest Federally Qualified Health Center (FQHC), AltaMed is at the forefront of providing affordable, high-quality health care to underserved communities in Los Angeles and Orange Counties. At AltaMed, you will have the opportunity to work with a diverse team of dedicated professionals who are passionate about making a difference and supporting our community of over 400,000 patients.

Learn About AltaMed: Click Here

AltaMed Health Services Corporation is committed to providing equal employment opportunities for all qualified individuals. We strictly prohibit discrimination in employment based on race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin, age, medical condition, physical or mental disability, military or protected veteran status, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical conditions, genetic information, or any other characteristic protected by local, state, or federal law, ordinance, or regulation.

We are committed to promoting equality and inclusivity beyond our recruitment and hiring processes. We aim to create a respectful, valued, and inclusive workplace through training, advancement opportunities, and access to resources and support. We focus on fostering a diverse workforce because it enriches our organization and improves our ability to effectively serve our clients and community. We encourage individuals from all backgrounds to apply and join us in our mission to create a positive impact.