Hybrid UM Denials Coordinator

Astrana Health; Monterey Park (CA); Hybrid; USD 28,929 - 35,817; Full time

Job summary

Astrana Health is seeking a Utilization Management Coordinator – Denials in Monterey Park, CA. This role involves processing denials and ensuring compliance with health regulations. Key responsibilities include managing communications, verifying eligibility, and maintaining data accuracy. The position requires a high school diploma and proficiency in medical terminology and UM software. It's a hybrid role with full office presence initially, transitioning to flexible home-office arrangements post-probation. The compensation range is $21.00 - $26.00 per hour.

Qualifications

• Required: High school diploma or GED. Knowledge of medical terminology, ICD-10, CPT, HCPCS.
• Must be proficient in Microsoft Office and UM software.
• Excellent verbal and written communication skills are essential.

Responsibilities

• Process and attach deferrals and denials accurately.
• Manage provider and interdepartmental communications.
• Verify member eligibility and maintain UM/Denial system data.

Skills

Communication skills

Organizational skills

Problem-solving skills

Knowledge of medical terminology

Proficient in Microsoft Office

Education

High school diploma or GED

Tools

UM software (e.g., InterQual, MCG)

Job description

Astrana Health is seeking a Utilization Management Coordinator – Denials in Monterey Park, CA. This role involves processing denials and ensuring compliance with health regulations. Key responsibilities include managing communications, verifying eligibility, and maintaining data accuracy. The position requires a high school diploma and proficiency in medical terminology and UM software. It's a hybrid role with full office presence initially, transitioning to flexible home-office arrangements post-probation. The compensation range is $21.00 - $26.00 per hour.