Hybrid Utilization Coordinator I - Healthcare

AltaMed Health Services; Commerce (CA); Hybrid; USD 77,108,000 - 96,077,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

403(b) Plan

Flexible Spending Accounts

Commuter FSA

Career Development

Paid Time Off & Holidays

CME Days

Tail Coverage

Tuition Reimbursement

Employee Discounts

Referral Bonus

Pet Insurance

Job summary

AltaMed Health Services seeks an Utilization Management Coordinator I in Commerce, CA to support the Senior Care Services/PACE department and ensure timely referral/authorization processing per state and federal guidelines. The role requires a High School diploma, with MA or Medical Billing Certification preferred, and at least 1 year in medical billing, pre-authorizations, and government programs.

This hybrid position offers a wage of $26.91–$33.53 per hour and a benefits package including

Qualifications

• High School Diploma or equivalent required.
• MA or Medical Billing Certificate preferred.
• Minimum 1 year of experience in medical billing environment (IPA or HMO preferred) with pre-authorizations and reimbursement regulations with Medi-Cal, CCS, and other government programs.
• Prior experience working in a clinic/health care specialty call center.
• Prefer experience in utilization management, processing authorization referrals.

Responsibilities

• Support timely processing of outpatient or inpatient referral/authorization per state and federal guidelines.
• Troubleshoot problem situations and coordinate with leadership.

Skills

Medical billing

Call center experience

Utilization management

Pre-authorizations

Regulatory knowledge

Education

High School diploma or equivalent

MA or Medical Billing Certificate preferred

Job description

AltaMed Health Services seeks an Utilization Management Coordinator I in Commerce, CA to support the Senior Care Services/PACE department and ensure timely referral/authorization processing per state and federal guidelines. The role requires a High School diploma, with MA or Medical Billing Certification preferred, and at least 1 year in medical billing, pre-authorizations, and government programs.

This hybrid position offers a wage of $26.91–$33.53 per hour and a benefits package including