Hybrid CalAIM Authorization Specialist

Libertana; Northern (KY); Híbrido; USD 33.000 - 34.000; Jornada completa

Descripción de la vacante

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.

Formación

• 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.

Responsabilidades

• 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.

Conocimientos

Communication skills

Phone etiquette

Organizational skills

Follow-up skills

HIPAA compliance

Educación

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

Herramientas

Microsoft Word

Microsoft Excel

Descripción del empleo

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.