Healthcare UM Referral Coordinator I

Universal Healthcare MSO LLC; Bakersfield (CA); Sur place; USD 29 000 - 36 000; Plein temps

Avantages offerts par ce poste

Medical

Dental

Vision

PTO

Floating Holiday

Simple IRA 3% Employer Contribution

Employer Paid Life Insurance

Employee Assistance Program

Résumé du poste

Universal Healthcare MSO LLC is seeking a Referral UM Coordinator Level I to support the Utilization Management team. The role focuses on handling a high volume of prior authorization requests and verifying eligibility, benefits, and contract status for requested providers.

Reporting to UM leadership, you will interact with UM staff, Medical Directors, providers, and health plans to ensure accurate processing and timely notifications while adhering to policies and procedures.

Qualifications

• High school diploma or equivalent required.
• 1-2 years in health care or related business environment preferred.
• General knowledge of EZCAP preferred.
• Proficiency in Microsoft Office applications: Excel, Word; Outlook.

Responsabilités

• Processes medical authorizations according to policies.
• Interprets CPT/ICD/hcpcs codes in billing/authorizations.
• Communicates contract or benefit language clearly.
• Collaborates with internal departments to obtain information.
• Verifies information in EZCAP and updates as needed.
• Contact providers/members regarding authorization outcomes.
• Maintains daily workload within TAT requirements.
• Assists in mailing, scanning, and data entry as required.
• Supports care continuity with external healthcare organizations.

Connaissances

Prior auth knowledge

CPT/ICD knowledge

Healthcare terminology

Communication skills

Customer service

Time management

Team collaboration

Formation

High school diploma

Outils

EZCAP

Microsoft Office

Description du poste

Universal Healthcare MSO LLC is seeking a Referral UM Coordinator Level I to support the Utilization Management team. The role focuses on handling a high volume of prior authorization requests and verifying eligibility, benefits, and contract status for requested providers.

Reporting to UM leadership, you will interact with UM staff, Medical Directors, providers, and health plans to ensure accurate processing and timely notifications while adhering to policies and procedures.